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 observe the therapeutic effect of thermosensitive hydrogel containing curcumin-vitamin E (VE) complex (hereinafter referred to as “curcumin-VE hydrogel”) on radiation-induced oral mucositis in mice. Methods Curcumin-VE hydrogel was prepared using the synthesized curcumin-VE complex as the carrier and poloxam as the substrate. The structure of curcumin-VE complex was characterized by Fourier transform infrared spectrometer, the microstructure of curcumin-VE hydrogel was determined by scanning electron microscope, and the gelation temperature was determined by rheometer, gel swelling and degradation were tested and gel adhesion was determined using a universal testing machine. Thirty healthy male BALB/C mice with specific pathogen free grade were randomly divided into three groups, with ten mice in each group. The radiation group and radiation+hydrogel group were modeled by a single high dose of radiation (25 Gy), while the control group had anesthesia but no radiation. The control group and radiation group were given daily feed and water 7 days after radiation. In addition to daily feed and water, the radiation+hydrogel group was given curcumin-VE hydrogel twice a day. The mice were sacreficed on the 8th day after radiation. The weight changes of each group were recorded after radiation. The ulceration area of tongue was measured by toluidine blue. The tongue of mouse were pathologically observed. The activities of superoxide dismutase, catalase (CAT), and glutathione peroxidase and the level of malondialdehyde in tongue tissue were determined. The levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 in tongue tissue were determined by enzyme linked immunosorbent assay. The distribution and positive expression of phosphorylated histone H2AX (γ-H2AX) and nuclear factor-erythroid 2-related factor 2 were determined by immunohistochemistry. Results Curcumin-VE hydrogel had a porous network structure and the gelation temperature was 30℃, the swelling rate was close to 300%, the gel degradation rate was up to 95% after 48 h, and the adhesion strength was 12.748 kPa. Compared with the radiation group, the weight of mice in the radiation+hydrogel group increased (P<0.05), the ulcer area decreased (P<0.05); the activity of CAT increased (P<0.05); the levels of TNF-α, IL-1β and IL-6 decreased (P<0.05); the expression of γ-H2AX was down-regulated (P<0.05). Conclusion Curcumin-VE hydrogel can delay or weaken the process of radiation-induced oral mucositis by reducing the DNA damage caused by radiation, inhibiting the production of reactive oxygen species, and effectively reducing the level of inflammation in tongue tissue.
【摘要】 目的 利用人體成分分析儀測定腫瘤化療患者人體組成,進而探討腫瘤化療患者人體成分組成特點及與營養狀況的關系。 方法 用人體成分分析儀于2008年4-5月對50例腫瘤化療患者行人體成分測定并分析。 結果 腫瘤化療患者人體細胞內液、外液,體內水分、蛋白質、礦物質、骨骼肌含量等成分存在不足,且有30％的腫瘤化療患者體脂肪含量過剩,40％體脂肪百分比超標。 結論 腫瘤化療患者由于疾病自身的高消耗,化療藥物對機體的影響,導致攝入不足,營養狀況較差,各成分含量均異常。其營養問題應受到重視,并采取積極有效的營養支持以改善營養狀況。【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.
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.
Objective To investigate the efficacy of dietary management based on the principles of enhanced recovery after surgery (ERAS) in bowel preparation for patients undergoing colonoscopy. Methods Patients undergoing colonoscopy procedures in the Department of Gastroenterology at West China Hospital, Sichuan University between December 2023 and December 2024 were randomly assigned to a control group and a trial group. The control group received conventional dietary management, comprising a self-prepared low-residue diet with fasting commencing at 22:00 on the preoperative evening. The trial group received dietary management based on the ERAS protocol, comprising pre-packaged low-residue meals on the day before surgery (lunch, dinner, and a 22:00 snack) plus 200 mL of clear liquids consumed 2 hours preoperatively. The Boston Scale and a subjective experience questionnaire (assessing preoperative and postoperative hunger, thirst, adverse reactions, etc.) were used to evaluate and compare bowel preparation quality and patient subjective experiences between the two groups. Results A total of 370 patients were included, comprising 194 in the control group and 176 in the trial group. Compared with the control group, the trial group showed no statistically significant difference in the Boston score for bowel preparation, the rate of adequate bowel preparation (78.41% vs. 71.65%), or the incidence of adverse reactions during bowel preparation or postoperatively (P>0.05). Patients in the trial group demonstrated higher subjective satisfaction with bowel cleansing (81.82% vs. 68.04%) and lower preoperative hunger [1.00 (0.00, 4.00) vs. 2.00 (0.00, 5.00)], with statistically significant differences (P<0.05). Conclusions Dietary management based on the ERAS concept does not increase the risk of bowel preparation failure or the incidence of adverse reactions during bowel preparation or postoperatively, compared with self-prepared low-residue diets. However, it reduces patients’ preoperative hunger and improves subjective satisfaction with bowel cleansing, making it worthy of promotion and application in clinical practice.
Objective To explore the effects of heat-inactivated Lactobacillus gasseri TMC0356 on liver lipid metabolism in rats with metabolic syndrome (MS) and its possible mechanism. Methods Sixty male Sprague-Dawley rats were selected. Rats were randomly divided into 5 groups, including control group, MS model group and three TMC0356 test groups (low-, medium- and high-dose groups). The rats in each group were fed with different diets for 7 days, and the liver was dissected and removed after 15 weeks. The mRNA and protein expression levels of peroxisome hyperbioactive receptor-α (PPAR-α), sterol regulatory element binding protein-1c (REBP-1c), fatty acid synthase (FAS) and carnitine lipoacyltransferase-1 (CPT-1) genes in liver were detected. Results There was no significant difference in the mRNA expression of PPAR-α, SREBP-1c or CPT-1 among the five groups (P>0.05). The mRNA expression of FAS in low-dose TMC0356 test group was lower than that in MS model group (P=0.011), medium-dose TMC0356 test group (P=0.042) and high-dose TMC0356 test group (P=0.009). There was no significant difference in the expression of FAS mRNA between other groups (P>0.05). There was no significant difference in the protein expression of PPAR-α, SREBP-1c or FAS among the five groups (P>0.05). The protein expression of CPT-1 in low-dose TMC0356 test group was higher than that in control group (P=0.033) and high-dose TMC0356 test group (P=0.043). There was no significant difference in the protein expression of CPT-1 between the other groups (P>0.05). Conclusion Heat-inactivated Lactobacillus gasseri TMC0356 may improve the symptoms of metabolic disorder in rats by suppressing appetite, improving insulin resistance, and downregulating the expression of key fat metabolism genes such as FAS and SREBP-1c.