【摘要】 目的 利用人体成分分析仪测定肿瘤化疗患者人体组成,进而探讨肿瘤化疗患者人体成分组成特点及与营养状况的关系。 方法 用人体成分分析仪于2008年4-5月对50例肿瘤化疗患者行人体成分测定并分析。 结果 肿瘤化疗患者人体细胞内液、外液,体内水分、蛋白质、矿物质、骨骼肌含量等成分存在不足,且有30％的肿瘤化疗患者体脂肪含量过剩,40％体脂肪百分比超标。 结论 肿瘤化疗患者由于疾病自身的高消耗,化疗药物对机体的影响,导致摄入不足,营养状况较差,各成分含量均异常。其营养问题应受到重视,并采取积极有效的营养支持以改善营养状况。【Abstract】 Objective To detect the body compositions of patients with carcinoma who had undergone chemotherapy, and to analyze the features of the composition and its relationship with nutritional status. Methods Bioelectrical impedance analyzer was used to measure and analyze the body compositions of 50 patients who was underwent chemotherapy from April to May 2008. Results The compositions such as intracellular and extracellular water, total body water, protein, minerals, skeletal muscle mass were insufficient in patients who had undergone chemotherapy; 30% of the patients had excess body fat, and 40% of the patients′ body fat percent was over standard. Conclusion Because of the high consumption of disease itself and the effects of chemotherapy drugs on the body, the intake of the patients who have undergone chemotherapy is insufficient and the nutritional status is poor. We should actively evaluate their nutritional status and do some effective nutritional supports to improve the nutritional status of patients with carcinoma who have undergone chemotherapy.
ObjectivesTo evaluate the quality of guidelines on nutrition in liver disease from 2017 to 2019, and to interpret these guidelines so as to provide references for clinical practice.MethodsComputer-assisted literature searches in CNKI, VIP, WanFang Data, Medline (Ovid), The Cochrane Library, PubMed and Medlive databases were performed by two reviewers for guidelines on nutrition in liver disease from January 2017 to July 2019. Two reviewers extracted data and assessed the methodological quality of the included guidelines using AGREE II, separately. Meanwhile, the intraclass correlation coefficient (ICC) was used to assess the degree of consistency.ResultsFour guidelines were included with 2 from China and 2 from Europe. Their average standardised scores in the 6 domains of scope and purpose, stakeholder involvement, rigour of development, clarity, applicability and independence were 79.17%, 71.53%, 78.13%, 85.42%, 61.98% and 43.75%, respectively. The Chinese and European guidelines had similar recommendations for energy and other nutrients, apart from differences in recommendations for protein intake. The European guidelines considered that restricting protein intake was not beneficial for patients with hepatic encephalopathy, while the Chinese guidelines argued that patients with severe hepatic encephalopathy were required to reduce or limit their protein intake.ConclusionsAll 4 guidelines are of average quality and are required to be strengthened in the ‘independence’ domain. Currently, the only consensus on nutrition therapy for liver disease and guidelines on nutrition in end-stage liver disease are available for references in China, with lower quality scores than that of the European guidelines. Therefore, the evidence-based guidelines on nutrition in liver disease should be developed by Chinese national conditions as soon as possible to provide references for clinicians, nurses and clinical nutritionists, enableing them to implement nutrition screening, evaluation, nutritional therapy and follow-up management for patrents with liver disease.
Objective To explore the correlations between nutritional markers and pressure injury (PI) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Retrospective analysis was conducted on elderly patients with COPD and PI who were admitted to the geriatric department of West China Hospital of Sichuan University or Dujiangyan People’s Hospital between January 2020 and December 2021. The blood biochemical indicators mainly including nutritional markers were collected, and their correlations with PI risk factor index Braden score and PI severity index PI stage were analyzed. Results A total of 293 patients with COPD and PI were included. Among the five Braden score groups, the differences in the levels of albumin and prealbumin were statistically significant (P<0.05), and the Braden score was positively correlated with albumin (rs=0.241, P<0.001), prealbumin (rs=0.179, P=0.002), and hemoglobin (rs=0.199, P=0.001). Among the six PI stage groups, the differences in the levels of albumin, globulin, red blood cell count, serum sodium, blood chloride and C-reactive protein were statistically significant (P<0.05), and the PI stage was negatively correlated with albumin (rs=−0.192, P=0.001), and positively correlated with serum sodium (rs=0.139, P<0.001), blood chloride (rs=0.184, P<0.001), and C-reactive protein (rs=0.177, P=0.020). Conclusion When PI risk assessment and severity assessment are performed on elderly COPD patients, it is necessary to pay more attention to nutritional markers and assess whether the patients are at risk of protein malnutrition, which will help to improve the accuracy of PI risk assessment and severity prediction, and effectively improve the efficacy of PI prevention and treatment.
ObjectiveTo evaluate the dietary and nutritional status of elderly patients with chronic non-infectious diseases in community hospitals in order to make a reasonable dietary pattern for these patients. MethodsA total of 179 elderly patients with chronic non-infectious diseases in a community hospital of Chengdu from January to September 2014 were collected, and we investigated them on their dietary status and basic personal information. The desirable dietary pattern (DDP) score was adopted to evaluate their dietary and nutritional status. ResultsDDP score of the 179 patients with chronic non-infectious diseases in the community hospital was 91.47, and the dietary quality was relatively good. While the DDP scores of animal food and edible oil exceeded the maximum allowable value, DDP scores of the staple food, fish, eggs, vegetables and fruits were lower than the expected scores. ConclusionIt is suggested that meat and other animal food intake be reduced and replaced by regular intakes of poultry, fish and shrimp, and the intake of staple food, eggs, vegetables, fruits be increased to ensure a balanced diet.
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 systematically evaluate the efficacy of probiotics in preventing antibiotic-associated diarrhea (AAD) in aged people. MethodsPubMed, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register, CNKI, VIP, and WANFANG electronic databases were searched for studies published, and references of included studies and reviews were screened from database inception to April 2014. Only randomized, controlled trials involving patients older than 65 years were included. Furthermore, only the trials which combined antibiotic administration and probiotic therapy for the prevention of AAD and Jadad score >3 were extracted. ResultsA total of eight articles containing 3 680 subjects (1 843 in the probiotic group, 1 837 people in the control group) met the inclusion criteria. Meta-analysis showed that there was no significant difference in the risk of antibiotic-associated diarrhea (AAD) between probiotics and control groups[RR=0.76, 95%CI (0.51, 1.13), P=0.17]. Further subgroup analysis found that compared with the control group, saccharomyces[RR=1.24, 95%CI (0.70, 2.19), P=0.46], lactobacillus[RR=0.59, 95%CI (0.31, 1.13), P=0.11], multi-probiotics combination[RR=0.58, 95%CI (0.24, 1.41), P=0.23] in the probiotics group were not significantly different. ConclusionThere is no evidence to support that probiotics can reduce the risk of AAD among aged people administrated with antibiotics therapy.