ObjectiveTo explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.MethodsA retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.ResultsThe detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).ConclusionUsing SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.
Sarcopenia has the characteristics of high morbidity and mortality, which seriously affects the quality of life of patients. Continuity of care, as an emerging nursing model in recent years, aims to improve self-care abilities of patients and their families, which can effectively reduce the rate of rehospitalization, and improve the quality of life of patients. This article starts with psychological intervention, nutrition guidance, patient exercise and medication guidance, and explores the application of continuity of care in patients with end-stage renal disease complicated with sarcopenia, analyzes the application of continuity of care in patients with end-stage renal diseases, and describes the implementation content and form of continuity of care, aiming to help its further promotion in clinic.
Sarcopenia is a syndrome associated with reduced strength, mass and function of skeletal muscles. Aging of gastric cancer patients, lack of nutritional intake, and pathological mechanisms of gastric cancer increase the likelihood of sarcopenia. Sarcopenia is associated with the development of gastric cancer and may be a risk factor for the formation of gastric cancer. Sarcopenia is closely related to the prognosis and treatment of gastric cancer. At present, the treatment of sarcopenia is still in the exploratory stage, and more research is needed to obtain better treatment plans and improve the quality of life of patients. This article reviews the research status of sarcopenia and gastric cancer in order to provide evidence for clinical research.
ObjectiveTo evaluate the quality differences in recommendations generated by large language models (LLM) and clinical practitioners for sarcopenia-related questions. MethodsA sarcopenia knowledge base was constructed based on the latest domestic and international research and consensus guidelines. Using the Python environment, a locally deployed and sarcopenia-focused hybrid vertical LLM (referred to as LC) was implemented via LangChain-LLM. Eight fixed questions covering etiology, diagnosis, and prevention were selected, along with eight virtual patient cases. The evaluation team assessed the quality of answers generated by LC and written by clinical practitioners. Quantitative analysis was performed on the precision, recall, and F1 scores (harmonic mean of precision and recall) of treatment recommendations. ResultsThe responses were generally perceived as "possibly written by humans or AI", with a stronger inclination toward being AI-generated, although the accuracy of such judgments was low. Regarding answer quality attributes, LC's responses were superior to those of clinical practitioners in guideline consistency (P<0.01), exhibited similar acceptability (P>0.05), showed better practicality (P<0.05), and had a lower proportion of "1–2 errors" (P<0.05). Quantitative analysis of treatment recommendations indicated that LC and GPT-4.0 outperformed clinical practitioners in recall and F1 scores (P<0.05), with minimal differences between LC and GPT-4.0. ConclusionThe locally deployed sarcopenia-focused hybrid vertical LLM demonstrates high accuracy and applicability in addressing sarcopenia-related issues, outperforming clinical practitioners and exhibiting strong clinical decision-support capabilities.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. This patient version of guideline has been developed by adapting the " Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline." This patient version of guideline is designed to enhance health education and promote the widespread adoption of comprehensive intervention strategies for sarcopenia.
Senile sarcopenia has become a prominent problem affecting the normal life and self-care ability of the elderly. More attention to the research on senile sarcopenia is conducive to its prevention and treatment. This article states information details about the epidemiology, influencing factors and mechanism, clinical manifestations and diagnostic criteria, evaluation methods and rehabilitation therapy, so as to provide reference for research on elderly sarcopenia.
Sarcopenia, characterized by the progressive loss of muscle mass and function, predominantly afflicts older adults. This condition is a notable risk factor for functional impairments, increased incidence of falls and fractures, and can escalate to mortality. Timely intervention is crucial to mitigate disability and minimize complications during hospitalization. The development of these guidelines adhered to an internationally recognized standard protocol. This involved framing clinical queries, pinpointing key outcomes, systematically gathering evidence, and appraising this evidence through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Subsequently, a consortium of experts convened to deliberate over the evidence, culminating in the formulation of these recommendations.
Objective To investigate the relevance among sarcopenia, peripheral inflammatory, and nutritional factors, as well as the impact of sarcopenia on the prognosis of gastric cancer. Methods A total of 174 patients with gastric cancer in Department of Gastrointestinal Surgery in West China Hospital of Sichuan University from July 2016 to December 2020 were retrospectively included. The skeletal muscle index (SMI) of the third lumbar vertebra level was calculated using CT images, and male patients with SMI<52.4 cm2/m2 and female patients with SMI<38.5 cm2/m2 were considered sarcopenia. The key clinicopathological features of patients were collected for prognostic analysis. ResultsAmong the 174 patients with gastric cancer, 73 patients (41.95%) were diagnosed with sarcopenia. Compared with those of non-sarcopenia, the patients who were diagnosed with sarcopenia showed a significantly elder age and lower body mass index (BMI). In addition, males demonstrated a significantly higher rate of sarcopenia. Further, patients with sarcopenia showed a significant increasing in the incidence of postoperative pulmonary infections and length of hospitalization than patients without sarcopenia. The two groups showed significant differences in type 2 diabetes, peripheral C-reaction protein (CRP), interleukin-6 (IL-6), albumin, prealbumin, and hemoglobin. Overall, the multivariate analysis and Kaplan-Meier survival curves indicated that sarcopenic patients had a significantly lower survival rate than the non-sarcopenia patients. Conclusion Sarcopenia is closely related to higher levels of inflammation, malnutrition, and poor prognosis in patients with gastric cancer. Therefore, we should diagnose sarcopenia patients as early as possible, and give nutritional support to the patients.
ObjectiveTo explore the changes of serum irisin in maintenance hemodialysis (MHD) patients with sarcopenia.MethodsFrom January to June 2019, 56 MHD patients from Shanxi Provincial People’s Hospital were selected. Judging by the results of body composition analyzer, the MHD patients were divided into the sarcopenia group (n=31) and the non-sarcopenia group (n=25). The serum irisin level was detected by enzyme-linked immunosorbent assay. The muscle cross-sectional area at the third lumbar level was measured by CT. SPSS 21.0 software was used for inter-group comparison, correlation analysis, and regression analysis.ResultsThe serum irisin concentration in the sarcopenia group was lower than that in the non-sarcopenia group [medium (lower quartile, upper quartile): 175.46 (126.00, 220.52) vs. 459.10 (233.83, 616.91) pg/mL; Z=?4.195, P<0.001]. The results of Spearman correlation analysis showed that serum irisin level was positively correlated with lean tissue index (rs=0.265, P=0.048), however negatively correlated with serum creatinine level (rs=?0.311, P=0.020). The results of logistic regression analysis showed that serum irisin level [odds ratio (OR)=0.957, 95% confidence interval (CI) (0.925, 0.990), P=0.012], walking speed [OR=0.000, 95%CI (0.000, 0.050), P=0.031], and grip strength [OR=0.658, 95%CI (0.434, 0.997), P=0.048] were protective factors of sarcopenia in MHD patients.ConclusionsThe level of circulating irisin in MHD patients with sarcopenia is lower than that in MHD patients without sarcopenia. Irisin is a protective factor of sarcopenia in MHD patients.
Objective To investigate the prognostic value of sarcopenia in patients with early non-small cell lung cancer (NSCLC) after surgery and chemotherapy. Methods This study included 592 patients with early non-small cell lung cancer who received lung cancer resection from January 2014 to December 2015, and they were divided into two groups: 473 patients received surgery alone (the surgery group), 119 patients received chemotherapy after surgery (the postoperative chemotherapy group), and the two groups were divided into sarcopenia group and non-sarcopenia group. General clinical data, laboratory data, and imaging data of these patients were compared. Results The median follow-up time of 592 patients was 69.1 months [95% confidential interval (CI) 64.9 - 78.2], and 110 patients were with sarcopenia (18.6%). Multivariate analysis showed that sarcopenia was an independent adverse prognostic factor in the surgery group [hazard ratio (HR) 6.56; 95%CI 1.86 to 14.78; P=0.01]. For patients undergoing postoperative chemotherapy, skeletal muscle mass index was reduced after chemotherapy, and sarcopenia was an independent predictor of poor prognosis (HR 5.77; 95%CI 0.96 to 20.60; P<0.05). Conclusions Sarcopenia is an independent poor prognostic factor for patients with early NSCLC undergoing surgery and postoperative chemotherapy. Assessment of sarcopenia before surgery and postoperative chemotherapy is helpful to improve the prognosis of patients with early NSCLC.