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 evaluate the efficacy of Wechat combined with continuing nursing on the quality of life of epilepsy children with ketogenic diet, parents' mood and the time commitment of medical staff. MethodsData were collected from 140 children with intractable epilepsy with ketogenic diet admitted to the Department of Neurology, Children's Hospital Affiliated to Chongqing Medical University from November 2014 to June 2022, including 116 males and 24 females, with an average age of (8.42±2.44) years. The random sampling method was divided into control group (continuing nursing) 71 cases, intervention group (Wechat combined with continuing nursing) 69 cases. The quality of life of the children (QOLCE-16) in the two groups was compared before discharge and 3 months after discharge, as well as parental anxiety (SAS), depression (SDS), and the amount of time medical staff spent with both groups. ResultsThere was no difference in the quality of life and parental emotion between the two groups before intervention. After 3 months, the quality of life of the two groups was significantly improved [(43.59±10.00) vs. (40.14±10.44), P<0.05], and the QOLCE-16 score of the intervention group was higher than that of the control group (P<0.05). The parental mood SAS and SDS in both groups were significantly improved [(37.19±2.90) vs. (50.85±3.76), (40.14±3.52) vs. (49.29±3.37), P<0.01], and the SAS and SDS scores of anxiety and depression of parents in the intervention group were lower than that of the control group (P<0.01). Medical staff spent more time on intervention group [(136.17±7.43) vs. (65.55±7.48), P<0.01]. ConclusionContinuing nursing can improve the quality of life of children with ketogenic diet and the negative emotions of their parents. The combination of Wechat and continuing nursing can further strengthen this positive effect, and requires more time of medical staff.
Objective To systematically review the efficacy and safety of a very low-calorie ketogenic diet (VLCKD) in patients who were overweight or obese. Methods From inception to August 2021, the electronic databases PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM were searched for randomized controlled trials (RCTs) of VLCKD in patients with overweight or obesity. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Then, meta-analysis was performed using Stata 16.0 software. Results A total of 5 RCTs involving 245 patients were included. Among patients with baseline body mass index (BMI) ≥30 kg/m2, the meta-analysis showed that compared with the control group, VLCKD could significantly reduce the BMI (MD=?0.24, 95%CI ?0.39 to ?0.08, P<0.05), weight (MD=?7.00, 95%CI ?10.48 to ?3.53, P<0.05) and waist circumference (MD=?7.40, 95%CI ?12.68 to ?2.12, P<0.05) . The subgroup analysis results showed that compared with the control diet, VLCKD could significantly reduce the glucose (MD=?9.60, 95%CI ?17.52 to ?1.69, P<0.05), glycated hemoglobin (MD=?0.24, 95%CI ?0.39 to ?0.08, P<0.05), insulin resistance index (MD=?0.90, 95%CI ?1.08 to ?0.73, P<0.05) and triglycerides (MD=?41.42, 95%CI ?53.78, ?29.06, P<0.05) in patients with type 2 diabetes and with obesity or overweight. In patients with obesity or overweight, VLCKD could increase high-density lipoprotein cholesterol (MD=8.60, 95%CI 0.17 to 17.03, P<0.05) when the intervention lasted longer than 12 months. In patients with obesity or overweight, VLCKD had no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Patients with VLCKD had a higher rate of adverse events than those in the control groups; however, there was no significant difference in the rate when the intervention lasted longer than 4 months. Conclusion The current evidence shows that VLCKD can reduce BMI, weight, and waist circumference and reduce fasting glucose, HbA1c, insulin resistance index, and triglycerides among patients with type 2 diabetes and with obesity or overweight. However, VLCKD has no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the impact on the retention and effective rate of the mode of continuous guidance with wechat group in children with infantile spasms (IS) treated by ketogenic diet (KD).MethodsThe clinical data of 40 children who received KD treatment in Jiangxi Children’s Hospital from January 2017 to June 2019 were retrospectively analyzed, including 23 males and 17 females, the average age was (19.90±13.10) months and the average course was (9.95±7.61) months. They were randomly divided into control group (20 cases) and observation group (wechat group continuity Guidance Group, 20 cases), and followed up one year to compare the retention rate and efficacy.ResultsThere was no statistical difference between the general data of the observation group and the control group (P>0.05). After 9 and 12 months of KD treatment, the retention and effective rate of the observation group was significantly higher than the control group (P<0.05). And the seizure-free rate was higher than the control group (35% vs. 10%, 35% vs. 15%).ConclusionThis model of continuous guidance with wechat group can increase the KD retention rate of IS children, And increase the effective rate.
ObjectiveTo explore the effects of mindful eating intervention on the dietary adherence and surgical outcomes for patients after bariatric and metabolic surgery. MethodsA total of 124 obese patients who underwent bariatric and metabolic surgery in the First Affiliated Hospital of Nanjing Medical University from May 2023 to May 2024 were recruited by convenience sampling method. The patients were randomly equally divided into the observation group and the control group respectively. Mindful eating intervention and routine follow-up management were given in the two groups respectively. The dietary aderence and the effects of bariatric and metabolic surgery were compared between the two groups. ResultsA total of 124 patients were included based on sample size calculation, with 62 patients in each group. The baseline characteristics, including gender, age, body mass index (BMI), surgical approach, and comorbidities, showed no statistically significant differences between the two groups (P>0.05). The points of dietary compliance, dietary control, and fluid intake in the observation group were all better than those in the control group (P＜0.05), while there was no significant difference in the points of nutrient intake and eating habits between the two groups (P＞0.05). Over time, the differences in the points of dietary compliance, dietary control, and fluid intake between the observation group and the control group gradually increased (P＜0.05), while there were no significant differences in the points of nutrient intake and eating habits between the two groups (P＞0.05). The BMI, percentage of excess weight loss, and remission of comorbidities in the observation group were significantly better than those in the control group at 6 months after surgery (P<0.05), there was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). ConclusionThe preliminary results of this study suggest that mindful eating intervention after bariatric and metabolic surgery can effectively improve patients’ dietary adherence and promote surgical results.
ObjectiveTo explore a surgery of effective weight loss concentrating on gut hormone release. MethodsWistar rats were fed with high-fat diet for inducing obesity and which randomly divided into sleeve gastrectomy plus decent jejunoileal bypass (SJB) group (n=12), sleeve gastrectomy (SG) group (n=12), and sham operation (SO) group (n=11), the body weight reduction, food intake, plasma ghrelin level, and glucagon like peptide-1 (GLP-1) level were compared among three groups. ResultsThere were no differences of the body weight and food intake before operation among three groups (Pgt;0.05). Compared with the SO group, the body weight descended and the food intake decreased obviously on 1-8 weeks after operation in the SJB group (Plt;0.05), the body weight of rats on 1-8 weeks after operation in the SJB group significantly descended as compared with the SG group (Plt;0.05), and the food intake of rats on week 3, 6, 7, and 8 in the SJB group signicantly decreased as compared with the SG group (Plt;0.05). There were no differences of the levels of the plasma ghrelin and GLP-1 before operation among three groups (Pgt;0.05). Compared with SO group, the plasma ghrelin level decreased and the GLP-1 level increased in the SJB group and the SG group, meanwhile the SJB group significantly decreased level of plasma ghrelin and elevated level of plasma GLP-1 as compared with the SG group on week 8 after operation(Plt;0.05). ConclusionThe data demonstrate that SJB could represent an effective way of losing weight by interfering with food intake and obesity related hormone levels.
ObjectiveTo explore the efficacy and safety of ketogenic diet (KD) in the treatment of drug-resistant epilepsy in children with malformations of cortical development (MCD). MethodsThe clinical data of 10 children with drug-resistant epilepsy caused by MCD treated in the Epilepsy Center of Children's Hospital affiliated to Shandong University from May 2021 to February 2023 were analyzed retrospectively. All of them received classical KD treatment for the first time. The patients were followed up at 1, 3, 6 and 12 months after KD treatment. The clinical efficacy was evaluated by Engel grade and the adverse reactions were recorded at the same time. ResultsThere were 10 patients in this study, including 5 males and 5 females. The age of onset was 0.2~36.0 (10.3±11.1) months, 2.0~31.0 (9.7±8.5) months, and the age of starting KD was 3.0~50.0 (20.0±15.7) months. Cranial imaging showed that there were 2 cases of hemimegalencephaly, 1case of lissencephaly, 1 case of pachygyria combine polymicrogyria, and 6 cases of FCD,3 had gene abnormality (2 cases of DEPDC5 gene, 1 case of ARX gene). All children had different degrees of developmental retardation before KD treatment. The antiseizure medications taken before KD treatment were 2.0~5.0 (3.2±0.9). 5/10 (50%) children had a >50% reduction in seizure frequency at 3 months on the diet, 2/10 (20%) children had a seizure free response. The rate of development improvement was 50.0% (5/10) at 3 months. 5 cases had mild adverse reactions (50%), including 1 case of hypokalemia and 4 cases of gastrointestinal reactions, all of which were relieved after the reduction of the proportion of KD diet. None of the children stopped using KD. ConclusionKD therapy is a safe and effective method for the treatment of drug-resistant epilepsy in children caused by MCD, and some children can improve their developmental level.
ObjectiveTo investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) in gross morphological classification of hepatocellular carcinoma (HCC). MethodsThe clinicopathologic data of patients with HCC who received surgical treatment in the Affiliated Huai’an Hospital of Xuzhou Medical University from January 2017 to December 2022 were retrospectively gathered. The Gd-EOB-DTPA-MRI was performed before operation. Two radiologists independently assessed the gross morphological classification of HCC according to the imaging performance. The tumors were cut into sections in a coronal plane and were taken pictures for recording pathological features after operation. The tumors were assigned into 4 types according to the references and clinical experiences: single nodular type (SN), single nodular with extranodular growth type (SN-EG), confluent multi-nodular type (CMN), and infiltration type (IF). Matching degree of morphological classification was analyzed between by the Gd-EOB-DTPA-MRI and resected specimen. The pathological features of 4 types of HCC were also analyzed. ResultsA total of 87 patients with HCC were included. The gross morphological classification by the Gd-EOB-DTPA-MRI was 28 (32.2%) patients with SN, 28 (32.2%) patients with SN-EG, 21 (24.1%) patients with CMN, 10 (11.5%) patients with IF, which by the resected specimen was 33 (37.9%) patients with SN, 24 (27.6%) patients with SN-EG, 21 (24.1%) patients with CMN, and 9 (10.4%) patients with IF in the 87 patients with HCC. The Kappa’s coefficient of agreement between the results of Gd-EOB-DTPA-MRI and postoperative resection specimens was 0.776 (P=0.199). There were statistical differences in the tumor diameter and microvascular invasion (MVI) among the 4 types of gross morphology classification (F=2.937, P=0.038; χ2=16.852, P=0.001), the MVI rate was highest and tumor diameter was biggest in the patients with IF among the 4 types of gross morphology classification (P<0.05). ConclusionsFrom the results of this study, the gross morphological classification of HCC is closely related to the tumor diameter and MVI. Results of Gd-EOB-DTPA-MRI and postoperative resection specimens in assessing the gross morphological classification are good agreement. Therefore, an accurate preoperative planning and better therapy strategy for the patients with HCC can be provided according to gross morphological classification by preoperative Gd-EOB-DTPA-MRI.
摘要:目的: 研究分析特殊飲食結構和生活習慣人群發生上消化道疾病的病種及發生率。 方法 :對1998年11月至2008年11月我院經胃鏡檢查的3661例患者進行統計,并參考飲食結構和生活習慣進行分析。 結果 :漢族調查2343例,彝族調查1318例:漢族患病率胃潰瘍1626%、十二指腸潰瘍858%、復合性潰瘍098%、糜爛出血性胃炎1434%、胃癌、食道癌089%;彝族患病率胃潰瘍2527%、十二指腸潰瘍1282%、復合性潰瘍25%、糜爛出血性胃炎1988%、胃癌、食道癌152%。 結論 :少數民族地區特殊飲食人群上消化道疾病發病率及胃、十二指腸潰瘍的發生率和癌變比率明顯增高。Abstract: Objective: To study the structure of the special diet and the lifestyle of people who occurred the upper digestive tract diseases and disease incidence. Methods : From 199811 t0 200811,3661 cases in our hospital carryed out statistics and analysis with reference to diet and lifestyle. Results : Han people with 2343 cases, Yi people with 1318 cases, in Han people, the rate of ulcer was 1626%,858% of duodenal ulcer,098% of compound ulcer,1434% of erosive hemorrhage gastritis,089% of stomach and esophagus; in Yi people,2527% of gastric ulcer,1282% of duodenal ulcer,25% of compound ulcer,1988% of erosive gastritis hemorrhage,152% of stomach and esophageal cancer. Conclusion : The upper digestive tract diseases, the incidence of stomach, duodenal ulcer and cancer incidence rate increased significantly in special diet groups in ethnic minority areas.
Objective To investigate the application effect of ndividualized dietary care based on a multidisciplinary collaboration model on glycemic control, neurological recovery, dietary self-management, and satisfaction in stroke patients with abnormal blood glucose. Methods Patients with stroke and abnormal blood glucose admitted to the Department of Neurology, Shangjin Hospital, West China Hospital, Sichuan University between March and October 2024 were enrolled. Using SPSS 26.0 software, a random allocation sequence was generated to divide participants into an observation group and a control group. The control group received comprehensive nursing interventions, while the observation group received additional multidisciplinary collaboration model based individualized dietary care. Both groups were intervened until discharge. Glycemic indicators [glycated albumin (GA), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG)], neurological recovery, dietary adherence, and patient satisfaction were compared pre-intervention and post-intervention (at discharge). Results A total of 112 patients were included, with 56 patients in each group. At the post-intervention stage, GA, FBG and 2hPG in the observation group were lower than those in the control group (P<0.05), and the scores of the Dietary Compliance Scale for Type 2 Diabetes were higher than those in the control group (P<0.05). Except for admission (3.27±0.86 vs. 3.25±0.90, P＞0.05), the modified Rankin Scale scores of the observation group were lower than those of the control group at discharge (3.14±0.86 vs. 3.17±0.86), 30-days follow-up (2.93±0.76 vs. 3.02±0.84), and 90-days follow-up (1.05±0.80 vs.1.43±1.01) (P<0.05). The comparison results within the group showed that, there were significant differences in GA, FBG, 2hPG, modified Rankin Scale scores and Dietary Compliance Scale for Type 2 Diabetes between admission and discharge (P<0.05). The satisfaction rate of the observation group was higher than that of the control group (97.78% vs. 86.76%; χ2=3.877, P=0.049). Conclusion Multidisciplinary collaboration model based individualized dietary care improves short-term glycemic control, promotes long-term neurological recovery, enhances dietary adherence, and increases patient satisfaction in stroke patients with abnormal blood glucose, demonstrating clinical value for widespread application.