A Cross-Sectional Study of GLIM-Defined Malnutrition Based on New Validated Calf Circumference Cut-off Values and Different Screening Tools in Hospitalised Patients over 70 Years Old.

BACKGROUND AND AIMS: The Global Leadership Initiative on Malnutrition (GLIM) is new criteria for diagnosing malnutrition that need validation adjusted to race. Our aim is to determine the optimal reference values of calf circumference (CC), investigate the prevalence of GLIM-defined malnutrition based on different screening tools in inpatients over 70 years old in China and assess its relationship with clinical outcomes. METHODS: We designed two continuity studies by analyzing a prospective multicenter database. First, we estimated and validated the CC cut-off values by receiver operating characteristic analyses against in-hospital mortality. Then the patients who were at risk by NRS 2002, MNA-SF and MUST were assessed by the GLIM criteria using the new CC values. Some clinical parameters and outcome data were evaluated. RESULTS: The optimal cut-off values of CC were 29.6 cm for male patients and 27.5 cm for female patients. The prevalence of GLIM-defined malnutrition was 27.5% by using NRS2002, 32.6% by using MNA-SF and 25.4% by using MUST. Patients with GLIM-defined malnutrition showed significantly worse values in BMI, total protein, albumin, neutrophil/lymphocyte ratio, CC, rate of complication, in-hospital mortality, length of stay, and total hospital cost than normal patients. Multivariate logistic regression showed the odds ratio of in-hospital mortality was significantly associated with GLIM defined malnutrition by using MNA-SF [OR = 1.231, 95%CI (1.022, 1.484), P = 0.029]. CONCLUSIONS: The Chinese reference values of CC for inpatients over 70 years old were validated by in-hospital mortality, which could be implemented in GLIM criteria. And this population possessed a high prevalence of nutrition risk and malnutrition. GLIM criteria with MNA-SF seems to be the first choice to diagnose malnutrition.

[The diversity of human hematopoietic stem/progenitor cells: VIII. Sterological features of CD 34+ hematopoietic cells isolated from human bone marrow].

Human CD 34+ hematopoietic cells, a distinctive cell population containing hematopoietic stem/progenitor cells, have the capability to highly self-renewal, differentiation into all lineages of committed progenitor cells and reconstitution of both long-term hematopoiesis and immune functions after transplantation. In our previous study, the morphological, ultrastructural and cytochemical features concerning CD 34+ hematopoietic cells obtained by a two-step isolated systems of CIMS-100/FACS 440 with 100% purity were depicted. Based on these observations on CD 34+ hematopoietic cells under light microscope, SEM and TEM, we recently analyze the sterological features of CD 34+ hematopoietic cells with the aid of Quantimet 970 automatic image analyser so that the three-dimension structures regarding CD 34+ hematopoietic cells could be further made clear. By a series of measures including image scan-->modulus transform-->shadow correction-->image store-->statistical analysis, some morphometric parameters of CD 34+ hematopoietic cells were obtained as the followings: diametrs 3.490-6.741 microns, perimeters 11.776-26.240 microns, surface area 9.565-35.686 microns2, form factors 1.048-1.840, nucleus-plasma ratio 0.55-0.72, mean light density 0.17675-0.65100, integral light density 2717.217-46661.000. These morphometric data combined with our previous results from morphology, ultrastructure and functional subsets of CD 34+ hematopoietic cells strongly demonstrate that CD 34+ hematopoietic cells are really a heterogenous population. The possible reasons causing heterogeneous are close associated with either different functional subsets or differentiation lineages. To our knowledge, this is the first identification of sterological features of CD 34+ hematopoietic cells.

Modulating activity of B lymphocytes on haemopoiesis (II)--the purification of proliferation amplifying factor (PAF).

In recent years we have done a series of observations on the haemopoietic modulation effects of lymphocytes. Now we report here, for the first time, the purification of a modulating factor (proliferation amplifying factor, PAE) with affinity chromatography and HPLC from supernatant conditioned by a lymphoma cell line M12.4.1. RAF exhibits on SDS-PAGE only one band, the molecular weight is about 31,000, the specific activity is 20,000 times that in the conditioned medium. It may provide a direct evidence that the B lymphocyte also possesses some haemopoietic modulation effects.