Diagnostic Value of Nutritional Risk Index and Other Indices for Predicting Sarcopenia in the Middle-Aged and Elderly Population of China Without Cancer: A ROC Curve Analysis.

Background: Emerging evidence suggests that systemic inflammatory and nutritional biomarkers, along with derived indices, could serve as predictors for sarcopenia in cancer population. This study aimed to compare these predictors, focusing on the nutritional risk index (NRI) and evaluate its diagnostic value, for sarcopenic patients without cancer. Methods: This cross-sectional retrospective study included 1674 participants. Sarcopenia is defined by skeletal muscle mass index (SMI). Laboratory data reflected the values of systemic inflammatory and nutritional biomarkers, from which the derived indices were calculated. Multiple logistic regression analysis, ROC curve analysis, and the Youden index were utilized to assess the association between these markers and sarcopenia and determine the cutoff value for predicting sarcopenia. Results: Among all participants (1110 men and 564 women, mean age 61.97 ± 9.83 years), 398 individuals were diagnosed with sarcopenia, indicating a prevalence of 23.78% in China's middle-aged and elderly population without cancer. Logistic regression analysis revealed significant associations between all biomarkers and derived indices with sarcopenia. Following adjustment for potential confounders, lower NRI values were significantly associated with a higher incidence of sarcopenia. For sarcopenia diagnosis, the area under the curve (AUC) for NRI was 0.769 ([95% CI, 0.742, 0.796], P < 0.001), with a cutoff value of 106.016, sensitivity of 75.6% and specificity of 66.1%. NRI demonstrated greater predictive advantage for sarcopenia incidence in men compared to women. Conclusion: A lower NRI value was associated with a higher prevalence of sarcopenia. NRI shows promise for early, rapid, and effective sarcopenia screening, particularly in China's middle-aged and elderly male population without cancer.

Severe bleeding after operation of preauricular fistula: A case report.

BACKGROUND: Severe eyelid edema and blood accumulation in the submandibular space after preauricular fistula surgery is rarely reported. CASE SUMMARY: We report a 4-year-old girl with eyelid edema and swelling of the submandibular region after preauricular fistula resection under general anesthesia. When drug treatment failed, neck computed tomography examination was performed, which confirmed severe bleeding in the submandibular space. Later, exploration and ligation of the superficial temporal artery were performed under general anesthesia to stop the bleeding. The child was successfully treated, and there were no abnormalities over 1 year of follow-up. CONCLUSION: When severe bleeding occurs after preauricular fistula surgery, superficial temporal artery rupture should be considered as a cause.

[Pollution Levels and Risk Assessment of Heavy Metals from Atmospheric Deposition in Nanjing].

In order to evaluate the pollution levels of and risk from heavy metals in the atmospheric deposition of different functional urban districts, dust samples were collected from 20 sampling sites in typical industrial, traffic, residential, and educational districts of Nanjing. The concentrations of As, Ba, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Sr, Ti, V, and Zn were analyzed. The potential ecological risk and health risk were evaluated using the potential ecological risk index and U.S. EPA's health risk assessment models. Enrichment factors, correlation analysis, and principal component analysis were used to analyze the sources of heavy metals. Results showed that the concentrations of As, Cd, Co, Cr, Cu, Fe, Mn, Pb, and Zn were the highest in the industrial district and the concentrations of Ba, Ni, Ti, and V were the highest in the traffic district. The value of the potential ecological risk index was the highest in the industrial district and lowest in the educational district. Meanwhile, the ecological risk of Cr was the highest, achieving a moderate ecological hazard level. None of the studied heavy metals had noncarcinogenic risk or carcinogenic risk, according to the results of health risk assessment. Source analysis indicated that heavy metals in the atmospheric deposition from the study areas were mainly from traffic and industrial activities, coal combustion, natural process and life sources.

[Feasibility of focused transthoracic echocardiography in intensive care unit performed by intensivists].

OBJECTIVE: To assess the clinical applicability of focused transthoracic echocardiography (TTE) in intensive care unit (ICU) performed by intensivists and its impacts on clinical managements. METHODS: After 12-hour tutorials and initial cardiac clinical assessments, intensivists performed a focused TTE (2-4 views of 2D, without Doppler or M mode) examination in 88 patients to assess left ventricular function and left ventricular volume status, and rule out local ventricular wall motion abnormalities and significant pericardial effusions. Each investigation was immediately reviewed by an echocardiograph to determine the technical quality of the TTE and the accuracy of the intensivist's interpretation. RESULTS: Intensivists successfully performed a diagnostic focused TTE in 86 patients (97.7%) and interpreted correctly in 75 patients (85.2%). Management including fluid treatment, inotropic agent and vasoactive agent in 22.7% of patients were changed directly based on the focused TTE, 45.5% of patients were provided with valuable information, while 31.8% of them with non-valuable information. The mean focused TTE acquisition time of the intensivist was (11.2±5.2) minutes. CONCLUSIONS: After a brief standard training in using echocardiographic system, intensivists can successfully performed and correctly interpreted a focused TTE for critically ill patients. Our study demonstrates that new information can be provided by focused TTE, which can alter management in a significant number of patients. The present study supports incorporating bedside goal-directed, focused TTE into intensivists' training programs in China.

[The expression of Neuritin protein in the visual cortex of monocular form deprived adult rats].

OBJECTIVE: To investigate the expression of Neuritin protein in the visual cortex of normal (N90), monocular deprived (MD) and reverse suture (RS) adult Wistar rats, explore whether the visual cortex of adult rats remains the plasticity. METHODS: It was an experimental research. The 35 healthy rats were divided into 7 groups, 5 in every group. The time-point for normal control and MD groups is postnatal 90 days. The time-point for RS group is 6, 12, 24, 48 h and 1 week under the RS rats were exposed to light environment. MD and RS groups were sutured right eyelid at postnatal 14 days up to postnatal 90 days. That time the right eyes were opened and the same time tarsorrhaphy was performed on the left eyes in RS groups. The visual cortex of left cerebrum in the normal control group and MD group were obtained in P90 rats, and those of RS group were acquired in corresponding time points. Expression of the Neuritin protein in the visual cortex of rats was detected by immunohistochemistry stain methods. RESULTS: Expression of Neuritin protein A of the group of N90, MD, RS 6 h, RS 12 h, RS 24 h, RS 48 h, RS 1 week were 0.1097±0.0136, 0.0259±0.0057, 0.04751±0.0069, 0.05189±0.0057, 0.0649±0.0055, 0.0835±0.0097, 0.0845±0.0098 (F=105.57, P<0.05), the count in the visual cortex of rats were 163.90±5.82, 142.00±3.65, 150.00±5.46, 152.10±5.04, 156.40±5.25, 156.40±6.04, 155.80±6.54 (F=15.39, P<0.05). The expression of Neuritin protein in the visual cortex of rats in the MD group was considerably lower than that of the normal control group. The expression of Neuritin protein in the visual cortex of rats in the RS 6, 12, 24, 48 h and 1 week group was evidently higher than that in the MD group. CONCLUSIONS: The dynamic change of Neuritin protein expression in the visual cortex of the MD rats and RS rats indicates that the visual cortex of adult rats with MD beyond the sensitive period of visual development remain the plasticity to some extent. It provides an experimental basis for the amblyopic treatment in elder children and adults.

[Study of CPG15 expression in the visual cortex of normal and monocular form deprived development rats].

OBJECTIVE: To explore the expression of CPG15 mRNA and protein the visual cortex of normal and monocular form deprived development rats, To explore the association CPG15 with visual development. METHODS: It was an experimental research. one hundred healthy Wistar rats were divided into 10 groups: the time-point for normal group is postnatal 7, 14, 21, 28, 45 days. The time-point for MD group is postnatal 21, 28, 45 days, 10 in every group. MD groups were sutured right eyelid at postnatal 14 days, and to make the model of monocular form deprived. Rats were housed in alike environment. To detect the expression of Neuritin mRNA and immuno-positive neurons protein in the visual cortex of normal and monocular form deprived rats by SYBR green I real-time fluorescent polymerase chain reaction and immunohistochemistry stain methods. RESULT: We found that: (1) The expression of normal and MD rats visual cortex CPG15 mRNA and immuno-positive neurons and the IOD of protein, significant deviation existed among different ages with one-factor analysis of variance (P < 0.05), and reached its climax in P28 and MD28. (2) The expression of CPG15 mRNA and immuno-positive neurons and the IOD of protein in MD group obviously lower than the normal group in postnatal 21, 28, 45 days, there was statistically different in that ages (P < 0.05). CONCLUSION: The expression of CPG15 mRNA and immuno-positive neurons and the IOD of protein in the development normal and MD rats show that the stage change by development vision. Its expression correlated with visual experience and age factor, and there was a high expression in critical period, and obviously influence by monocular form deprived. So we supposed that CPG15 may affect development and maturation in the visual cortical neuron. It may be the one of molecular basis to participated in visual developmental plasticity.