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.
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.
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.