ObjectiveTo explore the diagnostic efficacy of Geriatric Nutritional Risk Index (GNRI) in malnutrition of elderly patients with chronic obstructive pulmonary disease (COPD) in outpatient department. MethodsOne hundred and five elderly outpatients with COPD were enrolled in the study, and their nutritional screening was carried out. The clinical and laboratory parameters of patients in the normal nutrition group (high GNRI group) and malnutrition group (low GNRI group) were compared, and the correlation analysis was conducted. The diagnostic efficacy of GNRI was evaluated based on the malnutrition universal screening tool (MUST). ResultsThe prevalence of malnutrition was high in COPD elderly outpatients. The prevalence of malnutrition in group D was 61.8%. There were significant differences between the two groups in body mass index, serum albumin, FEV1 percentage in the predicted value, 6-minute walk distance, and the number of acute exacerbations in the past year. GNRI was significantly related to the above parameters. The sensitivity, specificity and accuracy of GNRI were 81.8%, 83.6% and 82.9%, using MUST as the standard. ConclusionGNRI can be used for nutritional screening of COPD patients in elderly outpatients, which is simple, convenient and relatively accurate, and can be popularized in other medical institutions.
Objective To assess the prevalence of malnutrition in patients with advanced non-small cell lung cancer (NSCLC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, analyze its associated factors, and explore the adverse effects of malnutrition on advanced NSCLC patients in multiple aspects. Methods Patients with NSCLC who were hospitalized for the first time in the Department of Oncology, Shangjin Hospital, West China Hospital, Sichuan University between January and December 2021 were retrospectively selected as the study objects. Malnutrition assessment was carried out in all patients according to GLIM criteria, and the current situation and related factors of malnutrition were analyzed. The Barthel index scale was used to compare the daily activity ability between the malnourished group and the non-malnourished group, the Quality-of-Life Questionnaire-Core 30 scale was used to compare the quality of life between the two groups, and the adverse reactions of the two groups were compared by the hospital information system course records. Results According to GLIM diagnostic criteria, 134 of 285 patients (47.0%) were diagnosed with malnutrition. The results of binary multiple logistic regression analysis showed that age [60-69 vs. <60 years old: odds ratio (OR)=2.323, 95% confidence interval (CI) (1.277, 4.397); ≥70 vs. <60 years old: OR=10.816, 95%CI (4.185, 27.959)], previous medical history [OR=2.740, 95%CI (1.313, 5.717)], and albumin level [OR=0.905, 95%CI (0.848, 0.965)] were associated with malnutrition in patients with advanced NSCLC (P<0.05). The daily activity ability and quality of life in the malnourished group were significantly worse than those in the non-malnourished group (87.57±12.48 vs. 91.82±6.77, P<0.05; 76.22±11.52 vs. 83.96±9.75, P<0.05), and the incidence of adverse reactions in the malnourished group was higher than that of the non-malnourished group (50.7% vs. 31.8%, P<0.05). Conclusions The prevalence of malnutrition in patients with advanced NSCLC is high, and advanced age, previous medical history and albumin are related factors of malnutrition in patients with advanced NSCLC. Combined malnutrition may have adverse effects on mobility, quality of life and adverse effects of anti-tumor therapy in advanced NSCLC patients.
【摘要】 目的 探讨使用营养风险筛查（nutritional risk screening，NRS）2002与生理生化指标联合评估大肠癌患者术前营养及二者的定量关系。 方法 对2008年4月-2009年3月收治的367例大肠癌患者，用NRS 2002与生理生化指标分别评估其术前营养风险和营养状况，对其进行相关性分析。 结果 有28%的大肠癌患者术前即存在营养风险，各评价指标对营养不良状况的检出率存在差异（9.3%～31.6%），且NRS 2002营养风险评分与血红蛋白（r=-0.117，P=0.025）、血清前白蛋白（r=-0.205，P=0.046）、血清白蛋白（r=-0.175，P=00.001）、体量质指数（r=-0.231，P=0.000）均呈负相关。 结论 大肠癌患者术前即存在较高的营养风险和营养不良，且营养风险与术前营养状况有关。【Abstract】 Objective To assess the preoperative nutritional risks and status of patients with colorectal cancer by nutritional risk screening 2002 (NRS 2002) combined with physiological-biochemical indicators, and explore their quantitative relationship. Methods NRS 2002 combined with physiological-biochemical indicators were applied on the 367 patients with colorectal cancer in Gastrointestinal Surgery Center in West China Hospital between April 2008 and March 2009 to assess their nutritional risks and status, and correlation analysis was done to explore their quantitative relationship. Results Among all the patients, 28% had preoperative nutritional risks. Different physiological-biochemical indicators detected different rates of malnutrition (9.3% to 31.6%), and there was a negative correlation between NRS 2002 and such physiological-biochemical indicators as hemoglobin (r=-0.117,P=0.025), pre-albumin (r=-0.205,P=0.046), albumin (r=-0.175,P=0.001), and body mass index (r=-0.231,P=0.000). Conclusion Many colorectal cancer patients have preoperative nutritional risks and malnurtrion, and the nutritional risks are correlated with preoperative nutritional status.
ObjectiveTo report the BEST1 gene mutations and clinical phenotypes in two pedigrees with Best vitelliform macular dystrophy (BVMD) and autosomal recessive bestrophinopathy (ARB)．MethodsA retrospective clinical study. From November 2019 to March 2021, in the Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University, the BVMD family (4 patients and 6 family members) and the ARB family (2 patients, 2 family members), a total of 6 patients and 8 normal family members were included in the study. Detailed medical history was obtained; best corrected visual acuity, fundus color photography, electrophysiology, optical coherence tomography and fundus autofluorescence examination were performed. The clinical characteristics for all patients in the two families were analyzed. Three milliliter peripheral venous blood of all participants in the family was collected, and the whole genomic DNA was extracted with gene sequencing using next-generation sequencing technology based on targeted capture. Compared with the database to identify the pathogenicity mutation sites, suspected pathogenic mutation sites were selected, then mutations in other members in the family was assayed by Sanger sequencing. ResultsIn family 1, the proband was demonstrated as typical BVMD, other patients were multifocal vitelliform macular dystrophy. The DNA sequencing result showed that all the 4 patients carried heterozygous missense mutations in exon 3 of BEST1 gene: c.240C>G (p.F80L) (M1) and 2 members carried this mutation, but without clinical phenotype. M1 was a likely-pathogenic mutation reported for the first time. In family 2, the proband and the other patient were diagnosed as ARB. The DNA result showed that the 2 patients carried heterozygous missense mutations in exon 5 and exon 2 of BEST1 gene: c.584C>T (p.A195V) (M2)、c.139C>A (p.R47S) (M3), and a heterozygous frameshift mutation in exon 3 of BEST1 gene: c.235dupT (p.S79Ffs*153) (M4). M2 was a pathogenic mutation reported previously. M3 variant was of undetermined significance. M4 was a first reported pathogenic mutation. ConclusionsThe BEST1 gene mutation is the main cause of BVMD and ARB. Different mutation sites have different clinical phenotypes. BVMD and ARB have genetic and clinical heterogeneity.
ObjectiveTo systematically review the therapeutic effects and safety of glucocorticoids (GC) for Duchenne muscular dystrophy (DMD). MethodsDatabases such as PubMed, EMbase, CENTRAL, CNKI, WanFang Data, VIP and CBM were electronically searched from the establishment of the databases till December 2011. All randomized controlled trials (RCTs) about GC for DMD were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and evaluated the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.0.2 software. ResultsA total of 6 studies involving 303 DMD children were included. The results of meta-analysis showed that after 6 month treatment of GC (deflazacort), patients' symptoms were obviously improved in average muscle strength, lift weight ability, forced vital capacity (FVC) of the lung, emotional factor scores and total scores in Quality of life (QoL), Gower's time, nine meters walking time (T9 m), and four-stair climbing time (T4 s). However, the trial group showed more weight gain, behavioural changes, increased appetite, cushingoid appearance, and excessive hair growth. The incidences of osteoporosis/fracture, hypertension, diabetes, and cataract were not increased. ConclusionGC could improve muscle strength and function, stabilize pulmonary function, prolong independent walk time, and improve QoL of DMD patients. However, adverse reaction caused by GC should be taken caution.
Objective To observe the efficacy of photodynamic therapy for vitelliform macular dystrophy(VMD) with choroidal neovascularization(CNV). Methods The clinical data of 7 patients (7 eyes) of VMD with CNV who had undergone photodynamic therapy (PDT) were retrospectively analyzed. The patients were 4 males and 3 females, aged from 20 to 54 years. The patients received the examinations of best corrected visual acuity (BCVA), slitlamp microscopy, fundus photography, fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral domain OCT(SD-OCT), electrooculogram（EOG）and electroretinogram (ERG)before and after PDT. The BCVA ranged from finger counting to 0.6. Retinal edema and the subretinal fluid were observed. The mean thickness of central retina was (506.00plusmn;30.71) mu;m. PDT was performed according to the standard treatment. The follow-up period ranged from 2 to 11 months with the mean of 6.3 months. The changes of BCVA, CNV and side effects were observed after treatment. Results BCVA improved in all patients ranging from 0.12 to 1.0. The regression of the CNV and resolution of the subretinal fluid were observed by FFA, ICGA and SD-OCT after PDT. The mean thickness of central retina was reduced to (401.00plusmn;52.22) mu;m. There was no PDTassociated ocular or systemic side effect. Conclusions PDT is an effective and safe treatment for VMD with CNV. It may improve or stabilize the visual acuity.