Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
目的 探讨口服海洋鱼皮胶原肽对人体皮肤水份和面部黄褐斑的影响。 方法 选择年龄在30～65岁、皮肤水份≤12者100名和年龄在18～65岁、面部有黄褐斑者100名，分别随机分为试验组和对照组（各50名），进行改善皮肤水份试验、祛黄褐斑试验。受试者每天摄入海洋鱼皮胶原肽2.7 g，连续30 d。在试验前后分别测定皮肤水份、面部黄褐斑的面积和颜色，调查受试者疲劳感、烦躁、睡眠、干涩等不适症状的变化，测定血常规、大小便常规和血液生化指标。 结果 皮肤干燥者口服海洋鱼皮胶原肽后，皮肤水份由（7.48 ± 2.39）增加至（8.68 ± 3.15），得到明显改善（P＜0.05），与对照组相比差异具有统计学意义（P＜0.01）；而对皮肤的油份和pH值没有影响（P＞0.05）。面部有黄褐斑者口服海洋鱼皮胶原肽后，黄褐斑的色卡值平均降低（0.35 ± 0.38）度，黄褐斑的面积平均缩小（4.70 ± 8.01） cm2。与试验前比较，两项指标均有明显变化（P＜0.01）；与对照组相比，两项指标差异有统计学意义（P＜0.05）。两组试验中，受试者疲劳感、烦躁、睡眠、干涩等不适症状均有明显改善；血常规、大小便常规和血液生化检查结果均无明显异常，亦未见过敏反应。 结论 口服海洋鱼皮胶原肽能够改善皮肤水份和祛面部黄褐斑，并有助于改善疲劳感、烦躁、睡眠、干涩等不适症状。
【摘要】 目的 探讨海洋肽对恶性肿瘤化学治疗（简称化疗）患者营养状况和免疫功能的影响。 方法 依照纳入排除标准选取2010年3－11月66例恶性肿瘤化疗患者，随机分为试验组和对照组，每组各33例。在正常饮食基础上，试验组和对照组分别服用海洋肽制剂和乳清蛋白制剂21 d，进行肝肾功能、营养状况及免疫指标的测定。 结果 干预前后两组肝肾功及血脂指标差异无统计学意义（Pgt;0.05），且均在正常范围内。试验组干预后体质指数（body mass index，BMI）、上臂围、上臂肌围、总蛋白、白蛋白、球蛋白、前白蛋白（prealbumin，PA）、转铁蛋白较干预前升高有统计学意义（Plt;0.05），而血红蛋白和三头肌皮褶厚度干预前后比较差异无统计学意义（Pgt;0.05）；对照组干预前后各指标差异均无统计学意义（Pgt;0.05）；试验组BMI、PA的前后差值较对照组高（Plt;0.05），而其他指标差值在两组间差异无统计学意义（Pgt;0.05）。两组在干预前后组内比较及组间免疫指标差值比较，差异均无统计学意义（Pgt;0.05）。 结论 海洋肽作为部分氮源应用于恶性肿瘤化疗患者，对患者的内脏蛋白、人体测量等均有一定的营养改善作用，但对免疫功能的影响不明显，尚待进一步研究。【Abstract】 Objective To investigate the effects of marine peptide on the nutritional status and immune function in malignant tumor patients undergoing chemotherapy. Methods According to inclusive and exclusive criteria, 66 malignant tumor patients undergoing chemotherapy from March 2010 to November 2010 were randomized into study group and control group with 33 patients in each group. The patients in the study group were given marine collagen peptide whey protein while those in the control group were given whey protein for 21 days. Liver and kidney function, nutritional status and immune function were observed before and after intervention. Results Liver, kidney function and blood lipids of all the patients were within normal range, and were not significantly different between the two groups before and after intervention (P＞0.05). After intervention, body mass index (BMI), arm circumference, arm muscle circumference, total protein, albumin, globulin, prealbumin (PA), transferring protein of the study group were significantly increased (P＜0.05), but hemoglobin and triceps skinfold thickness had no significant changes (P＞0.05). There was no significant difference of the above parameters in the control group before and after intervention (P＞0.05). The magnitude of change of PA and BMI before and after intervention were higher in the study group than those in the control group (P＜0.05), while the magnitude of change of other parameters before and after intervention showed no significant difference between the two groups (P＞0.05). The immune function showed no significant change in both groups before and after intervention (P＞0.05), and it was also not significantly different between the two groups. Conclusion As part of dietary nitrogen sources, marine peptide can significantly improve nutritional status, including visceral protein and anthropometry in malignant tumor patients undergoing chemotherapy, but it has no significant effect on immune function, which should be further studied in detail.
ObjectiveTo explore the relationship between the diet during pregnancy and gestational diabetes mellitus (GDM), and analyze the effect of GDM on weight gain, outcome and complication of mother and infant. MethodsWe selected 128 GDM pregnant women and 267 non-GDM pregnant women who were investigated by semi-quantitative food frequency method during September 2009 to March 2011. Then, we collected relevant information and the data were analyzed by t-test and chi-square test. ResultsThere were statistically significant differences between the two groups in total calorie, carbohydrate, fat and protein intakes per day (P<0.05). In general, the rates of insufficient weight gain and excessive weight gain during pregnancy in the GDM group were significantly higher than the non-GDM group (P<0.05), while proper weight gain rate was significantly lower (P<0.01). The risk of hydramnion, intrahepatic cholestasis and pregnancy-induced hypertension in the GDM group was significantly higher than the non-GDM group (P<0.05), while there was no significant difference between the two groups in premature delivery, cesarean section or premature membrane ruptures (P>0.05). Apgar scores were significantly different at minute 1 and 5 between the infants in the two groups (P<0.05). The incidence of fetal death, malformation, mild neonatal asphyxia and fetal macrosomia in the GDM group was significantly higher than the non-GDM group (P<0.05). No significant differences between the two groups in low birth weight infant, cord entanglement and fetal distress were detected (P>0.05). ConclusionGDM can lead to high incidence of poor outcome and complication. It is vital to strengthen the examination and keep balanced dietary structure, in order to reduce the complication and improve the health of mother and child.
ObjectiveTo study the differences in body composition between maintenance hemodialysis (MHD) patients with reduced muscle mass and the ones with normal muscle mass by bioelectrical impedance analysis, and explore the influencing factors.MethodsA total of 122 patients undergoing MHD in the hemodialysis center of a general hospital between September 2018 and May 2019 were selected as the research subjects. According to the relative skeletal muscle mass index, they were divided into the muscle loss group and the normal muscle mass group. Their general conditions, post-dialysis body composition, and serum albumin were collected to analyze the differences between the two groups, and a multiple stepwise logistic regression analysis was carried out.ResultsAmong the included subjects, 53 patients had normal muscle mass and 69 patients had muscle mass loss. The post-dialysis body weight, muscle-related indexes, intracellular water, extracellular water (ECW), total body water (TBW), protein, minerals, body cell mass, bone mineral content, body mass index, arm circumference, and arm muscle circumference in the normal muscle mass group were higher than those in the muscle loss group (P<0.05); the percentage of ECW/TBW in the normal muscle mass group was lower than that in the muscle loss group (P<0.05). The multiple stepwise logistic regression analysis showed that the post-dialysis weight [odds ratio (OR)=0.679, 95% confidence interval (CI) (0.535, 0.862), P=0.001] was a protective factor from losing muscle in MHD patients, and the high ECW/TBW [OR=6.926, 95%CI (1.014, 47.280), P=0.048], low body cell mass [OR=57.707, 95%CI (6.927, 480.761), P<0.001], low bone mineral content [OR=9.743, 95%CI (1.220, 77.831, P=0.032], and arm circumference [OR=2.183, 95%CI (1.004, 4.749), P=0.049] were risk factors for muscle loss in MHD patients.ConclusionsMHD patients have a high incidence of muscle loss. It is necessary to monitor the changes of their body composition, especially those who with low post-dialysis body weight, lack of bone minerals and body cells, excessive ECW/TBW, and increased arm circumference after hemodialysis. Both nutritional interventions and exercise interventions should be performed timely and routinely to prevent the occurrence of sarcopenia.
ObjectivesTo use the Delphi method to preliminarily perfect the comprehensive evaluation index system which had been initially constructed by systematic review processes of diabetes food for special medical purposes (FSMP).MethodsThree rounds of expert consultation by Delphi method were compared to define indices held in the evidence-based comprehensive evaluation index system of diabetes FSMP and ways to distinguish effects.ResultsThe preliminary perfect index system after 3 rounds of expert consultation contained 4 primary directory indicators, 15 secondary directory indicators, and 20 tertiary indicators. Among them, the end index which could directly be used for evaluation contained a total of 27 indicators.ConclusionsThe index system is categorized into 4 segments of parameters, which are medical, nutritional, safety and other indices, which has addressed the problem posed by CFDA documents on how to scientifically validate the medical effect and safety of FSMP. It provides great significance to assess and supervise FSMP prior to and after it goes to public, assess characteristics and advantages of MNT, and improves nutrition economy and its social benefits.
The essence of ensuring universal nutritional health lies in achieving a balance between the growing demand for nutritional health and the supply of adequate and balanced nutritional services. This paper learns and draws on the ideological theory and methodological support of evidence-based science, optimizing practices, reevaluations, monitoring risks, producing evidence and cultivating talents so as to enable the interdisciplines of evidence-based nutrition and develop in a localized way and gain optimal timeliness, quantity and quality.