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Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.
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A novel solid-phase extraction (SPE) adsorbent for simultaneous extraction of atrazine (ATZ) and its metabolites, deisopropylatrazine (DIA) and deethylatrazine (DEA) from environmental water samples was prepared. Polyacrylonitrile nanofibers (PAN NFs) mat was prepared via electrospinning, and was further functionalized to obtain polypyrrole modified polyacrylonitrile nanofibers (PPy-PAN NFs) mat, hydrazine modified polyacrylonitrile nanofibers (NH2-PAN NFs) mat and carboxyl modified polyacrylonitrile (COOH-PAN NFs) mat. The results showed that the adsorption capacity of COOH-PAN NFs mat was better than other three NFs mats in both static (2.0 mg/g) and dynamic (0.19 mg/g) experiments. Meanwhile, the runoff ratios of COOH-PAN NFs mat were the lowest (less than 30.0％) in the adsorption of three analytes, especially for high polar analytes, which showed that the hydrogen bond between carboxyl groups and analytes was the main interactive force. A combination of mat-based SPE and high performance liquid chromatography-diode array detection was further established for determination of 3 analytes in environmental water samples. The recoveries were 81.4％-120.3％ and the limits of detection were 0.12 ng/mL for DIA, 0.09 ng/mL for DEA and ATZ, respectively.
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To explore the effects of nutritional risks on clinical outcomes [length of stay (LOS),hospitalization expense & mortality] in chronic kidney disease (CKD) patients.A total of 127 CKD patients completed the screening of nutritional risks by Nutritional Risk Screening 2002 (NRS-2002) within 24-48 hours of admission.The data of nutritional supports within 2 weeks of admission,LOS,hospitalization expense and mortality were collected.① Among them,the prevalence of nutritional risks was 18.1％.And the values were 8.2％,9.4％ and 44.1％ in early,middle and advanced CKD groups respectively; ② LOS and hospitalization expense in nutritional risk group were significantly more than the non-nutritional risk group (12.5 d vs.5.2 d,P =0.00 ; 11 806 vs.5311 yuan,P =0.00).There was a positive correlation between NRS score and LOS or hospitalization expense; ③ The nutritional support rate of nutritional risk group was only 17.4％.The progression of CKD increased the nutritional risks leading to greater LOS and hospitalization expense.We should pay more attention to the nutritional risk screening and nutritional intervention in moderate-advanced CKD patients.
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Operable cancer patients should receive nutritional risk screening or/and nutritional assessment before surgery.Perioperative nutrition support therapy should be planned and implemented for the patients with nutritional risk or malnutrition,but not necessarily following special nutritional formula.Reducing the time of preoperative fasting,providing reasonable preoperative nutrition support,and early postoperative feeding in combination may be the preferred strategy for perioperative nutritional intervention and management.Because the disease of cancer patients is complicated and changeable,perioperative nutrition support is not only a technology,but also an “art”.The guidelines,disease information,and clinical experience should be “cleverly tailored and combined” to promote the outcome-improving effect of nutrition support therapy.
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Objective To investigate bone strength in adults,and explore its influencing factors. Methods One hundred and ninety-one adults undergoing health examinations were selected.The questionnaires about milk intake and exercise conditions were performed,the body weight,fat mass,body mass index(BMI)and calcaneal bone strength were measured,and the relationship between each parameter and bone strength was analysed. Results Bone suength decreased with age increase,and was higher in males than that in females.Bone strength of overweight to obese adults was higher than that with normal body weight(P<0.05).Bone strength of adults with high milk intake was higher than that of those with low milk intake(P<0.05).Multivariate analysis revealed that age was negatively related to bone strength,females were more susceptible to bone strength decrease,and BMI and milk intake were positively related to bone strength. Conclusion Gender,age,BMI and milk intake are main influencing factors for bone strength.Bone strength decreases with age increase,and increase of BMI and milk intake will benefit bone strength,especially for females.
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Objective To establish a comprehensive nutritional assessment scale for hospitalized patients with objective and subjective nutritional assessment indicators. Methods The hierarchical structure model was established to evaluate the nutritional status of hospitalized patients by analytic hierarchy process,and the weight coefficients of various assessment indicators were worked out by Satty product method,then the comprehensive nutritional assessment scale for hospitalized patients was established. ResuIts The newly established comprehensive nutritional assessment scale included 11 subjective and objective indicators,and the weight coefficients of indicators varied.The leading three important indicators for nutritional assessment were serum prealbumin(2.3),serum albumin(2.3)and degree of weight loss(1.6).Conclusion With both snbjective and objective indicators,the new comprehensive nutritional assessment scale established with analytic hierarchy process transforms the qualitative indicator into the quantitative one.It is a new attempt to apply the mathematical theory into the area of clinical medicine.
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Sepsis may result in a high mortality.Fish oil,which riches in ω-3 polyunsaturated fatty acids.has anti-inflammatory and immune regulatory functions.ω-3 fatty acids,which are special immune nutrient substrates,participate in the energy provision as well as improve organ function and regulate proinnammatory/anti-inflammatory cytokines.The ideal function of fish oil is associated with dosage,time of initiation and duration of application.
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Objective:To investigate the effect of combination of D-methionine and docetaxel on gastric cancer cells. Methods:First, seven gastric cancer cell lines were cultured with three different kinds of media (D-Met, L-Met and Met~ - ) for five days, and cell cycle was detected by flow cytometry. Second, gastric cancer cells were respectively cultured in L-Met, D-Met, and Met~ - media for 96 h, then docetaxel was added into 3 media. After 24 h, proliferation was measured by MTT method. Results:All gastric cancer cell lines were arrested in G_ 2 /M phase (P
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Objective: To investigate the mechanism of butyrate,which is the by-products of diet fiber fermented in colon and induce the apoptosis of human colon cancer cell. Methods: The subculture of human colon cancer cell line SW1116 was cultured in medium with different concentration of butyrate(0、2 、3 、4、7 and 10 mmol/L).The mRNA and proteins of bcl-2 or bax in cell lines were detected respectively by RT-PCR and Western Blotting while the concentration of p53 protein and the activity of caspase-3 was detected by flow cytometer and fluorescent quantitative assay respectively after 6、24、48 and 72h cultivation.Results: There was no expression of bcl-2 mRNA and its protein in SW1116 cell during the study periods but the expression of bax mRNA and its protein,the p53 protein concentration and the caspase-3 activity increased gradually when the butyrate concentration was increased and the cultivation time was prolonged. Conclusion: By up-regulating the expression of bax mRNA and its protein,butyrate induce the apoptosis of colon cancer cell on a p53 dependent way.
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Objectives: To investigate the effect of butyrate, the by-products of diet fiber fermented in colon, on the apoptosis of human colon cancer cell and its mechanism for colon cancer prevention. Methods: The subculture of human colon cancer cell line SW1116 was cultured in medium without or with different concentration of butyrate(2、3、4、7 and 10 mmol/L). The cell proliferation rate and apoptosis were measured by MTT and flow cytometer or electro-microscopy respectively after 6、24、48 and 72 cultivation. Results: By the increasing of butyrate concentration and cell culture time, the proliferation of SW1116 cell was inhibited gradually with a highest rate of 59.19% during the study period. The percent of G 1 cell was increased gradually whereas the percent of S cell was decreased. The apoptosis rate of SW1116 was increased gradually with a highest rate of 30.62% at the same time. The ultrastructure of SW1116 cell was changed after butyrate was added to culture medium. Conclusions: Butyrate could not only inhibit the proliferation of colon cancer cell line but also induce it apoptosis.
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n 3 fatty acids belong to essential fatty acids. It includes linolenic acid, eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ). Many researches proved that n 3 fatty acids can suppress many kinds of tumor cells, and defense the occurrence of tumor. This article reviewed the effects and mechanism of n 3 fatty acids in defension and suppression of tumor.
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Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.
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Objectives:To assess the nutritional status of retired residents in a community by mininutritional assessment(MNA) combined with anthropometry. Methods:MNA questionnaire and anthropometric parameters including waistline,hipline,height,weight,body mass index(BMI),midarm circumference,triceps skinfold(TSF) and midarm muscle circumference were performed in 115 retired residents. Results:①24 (20.9%) residents had MNA scores less than 23.5,which meaned malnutrition or at risk of malnutrition.②According to each single index,namely waistline, waist hip ratio and BMI,incidence of obesity was 53.9%,61.7% and 65.2% respectively.③According to each single index,that is,midarm circumference,TSF and midarm muscle circumference,prevalence of moderate or severe malnutrition was 1.7%,19.1% and 2.2%respectively.④There lied a significant correlation between MNA score and several anthropometric parameters. Conclusions:①Both overnutrition and undernutrition can be manifested in retired home residents,for whom nutritional intervene should be enhanced.②MNA questionnaire can be well used in Chinese.
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Oxidative stress induced injury mediated by active oxygen radicals(AOR) is one of important pathophysiologic characteristics in critical illness such as severe trauma,shock,sepsis and pancreatitis.Large amounts of AOR can be generated and the function of antioxidant system will be severely compromised with the result of an imbalance between oxidative and anti oxidative.Supplementation with anti oxidant via nutrition supports may be an important way to reduce oxidative stress induced injury in critical care.But there are some problems such as the timing,methods,dosage,safety and effectiveness of this regime.
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Objectives:To study the methionine dependence (Met-dependence) of human primary gastric cancer cells in vitro when Met in the culture medicine was replaced by its precussor homocysteine(Hcy). Methods:Fresh and sterile gaotric cancer samples and normal gastric mucosa were managed into single-cell suspension and were cultured in the Met -Hcy + and Met\++ Hcy\+- medium separately.proliferation of these cells in the two different culture media was examined by cell counter and flow cytometry (FCM). Results:In the Met\++Hcy\+- medium,the growth of primary gastric cancer cells was inhibited,manifesting that the percentage of G 0G 1 tumor cells decreased and that of the S phase increased signiflcantly.However,normal gastric mucosal cells grew well and their cell cycles had no change. Conclusions:Human primary gastric cancer cells are Met dependent in vitro whereas normal gastric mucosal cells have no similar results.
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Objectives:To study the methionine dependence(Met dependence) of human primary gastric cancer cells in vitro when Met in the culture medium was replaced by its precursor homocysteine(Hcy),and the effect of methionine starvation in combination with chemotherapeutical agents on gastric cancer cells. Methods:Fresh and sterile gastric cancer samples were managed to single cell suspensions and then were cultured in Met -Hcy + and Met +Hcy - medium separately,the proliferation of tumor cells in different culture media was examined by microcytotoxicity(MTT) assay.Meanwhile,the inhibition rate of tumor cells by ADM、DDP、5 FU、MMC and MTX in Met -Hcy +medium was separately tested. Results:①In Met -Hcy + medium,the human primary gastric cancer cell decreased;②Methionine deprivation in combination with chemotherapy enhanced obviously the killing capacity of each chemotherapeutical agent. Conclusions:①Human primary gastric cancer cells in vitro appears Met dependent.②The combined application of Met -Hcy + medium and different chemotherapeutical agents could enhance the antitumor effect of chemotherapy on primary gastric cancer cells.③MTT assay was an efficient way to examine the sensititivity of methionine starvation therapy combined with individualized chemotherapeutical agents.
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Objective:To study the expression of D-amino acid oxidase(DAO) in gastric cancer cells and gastric mucosa cells. Methods:The expression of DAO was detected in seven gastric cancer cell lines and a normal gastric mucosa cell line GES-1 by real-time quantitative PCR and in tumor tissues and normal gastric mucous tissues of 46 patients with gastric cancer by RT-PCR.The liver and kidney tissues of nude mouse acted as positive controls.Results:DAO was expressed in the liver and kidney tissues of nude mouse,and DAO expression in kidney tissue was higher than that in liver tissue.DAO was not detected in seven gastric cancer cell lines and the normal gastric mucosa cell line GES-1.Except one tumor tissue sample,DAO was not detected in other gastric cancer tissues and all normal mucosa tissues.Conclusion:DAO was not expressed in gastric cancer cells and gastric mucosa cells.The nutritional treatment of D-Met in place of L-Met could avoid the disadvantage of methionine starvation to important organs,such as liver and kidney.
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Glutamine is the most abundant free amino acid in the body,which is regarded as a conditionally essential amino acid under the conditions of stress and hypermetabolism.It has been proved that glutamine can enhance the proliferation of immune cells and the repair of impaired mucosa and can also improve the nitrogen balance and skeletal muscle protein synthesis.Therefore,it is now more and more widely used in the bone marrow transplantation.The roles of glutamine in the prevention and treatment of bone marrow transplantation-related mucositis and veno-occlusive disease are reviewed in this article.
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Methionine dependence is one of characteristic metabolism deficiency in cancer cells.Recently a series of researches focusing on key enzymes of methionine metabolism demonstrated that several molecular events might relate with cancer cell methionine dependence(i.e.,methionine synthasesingle nucleotide polymorphism,methythioadenosine phophorylasegene deletion,down regulation of thymidylate synthase translation;up regulation of methylenetetrahydrofolate reductase expression).Cell apoptosis induced by intracellular signal transduction dysfunction might be another potential mechanism.
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Many malignant tumor have methionine dependency. Methionine restriction can inhibit proliferation of tumors cells by decreasing the level of methionine with depriving methionine, methioninase, homocysteine, and its analogs.Methionine restriction may act synergistically with chemotherapies to increase their efficiency and /or reduce their toxic side effects.Therefore, methionine restriction would become a new cancer treatment.