Risk factors for inpatient malnutrition and length of stay assessed by 'NutritionDay' in China.

BACKGROUND AND OBJECTIVES: NutritionDay is a yearly global point-prevalence study of malnutrition or nutritional risk in hospitals. We aimed to provide a comprehensive nutritional survey of hospitalized patients and analyze the risk factors of malnutrition and prolonged hospitalization in Chinese inpatients. METHODS AND STUDY DESIGN: The international daylong cross-sectional survey was performed on November 07th, 2019. Ten hospitals were invited to participate in this NutritionDay survey. Nutritional risk was identified by nutritional risk screening 2002, and malnutrition was identified by the ESPEN criteria. We measured the incidence of malnutrition and nutritional risk. And we analysed risk factors for malnutrition and length of stay in Chinese hospitalized patients. RESULTS: 875 hospitalized patients from 6 departments were included in the analysis. The malnutrition rate was 11.6% and the incidence of nutritional risk was 17.8%. It was analyzed that tumor load, end-stage disease, motility, self-rated health, types of oral medicine, and food intake during the past week were independent risk factors for malnutrition or nutritional risk. 56.2% (118/210) of patients at nutritional risk or malnutrition received extra nutritional support, whereas 22.5% (88/391) well-nourished patients did. Moreover, nutrition status, ever stayed in ICU and self-rated health were associated with prolonged length of stay. CONCLUSIONS: In a word, the prevalence of malnutrition or nutritional risk was about 29.4%. Patients with malnutrition or nutritional risk had a higher transfer rate, lower rehabilitation rate and longer hospital stays. The attention to malnutrition patients needs to be further strengthened.

Hepatic cortical blindness.

Hepatic cortical blindness is an unusual clinical complication of hepatic encephalopathy, and its epidemiology has not been studied in detail. Herein, we present a case report of a 37-year-old male with liver cirrhosis and immunoglobulin A nephropathy who noted visual impairment after eating high-protein food. In addition to the case report, all previously documented cases of hepatic cortical blindness occurring across the globe published from inception until August 2019 were reviewed. The incidence of hepatic cortical blindness is low, and diagnoses are easily missed. The diagnosis of hepatic cortical blindness is dependent on symptoms, and patients may experience several attacks of vision loss. Most patients experience complete blindness, but vision loss recovers within 10 min to one month. Early detection and therapy for hepatic encephalopathy may improve patient outcome.

Gastroprotective effects of diosgenin against HCl/ethanol-induced gastric mucosal injury through suppression of NF-κß and myeloperoxidase activities.

Gastric mucosal injury is caused by an imbalance between the mucosal defense and gastro-irritants, leading to gastroenteritis. Diosgenin is a steroidal sapogenin found in the wild Yam plant that has been reported with several pharmacological properties. The aim of this study is to explore the gastroprotective role of diosgenin on gastric mucosal damage caused by HCl/ethanol in rats. Male Sprague-Dawley rats were intragastrically administered with diosgenin (20 mg/kg) before HCl/ethanol (0.15 M HCl in 98 % ethanol) administration. Omeprazole was used as a positive control. Diosgenin-attenuated oxidative stress by enhancing (p < 0.05) antioxidant enzymes, reducing lipid peroxidation (MDA), and modulating nitric oxide (NO) levels. Anti-inflammatory effects of diosgenin were observed by a reduction in pro-inflammatory cytokines (p < 0.05), decreased myeloperoxidase (MPO) activities (p < 0.05), and histopathological observation of gastric mucosal damage. Western blot analysis provided evidence on the downregulation of NF-κß by diosgenin. The findings showed that diosgenin has a significant protective role on gastric injury caused by HCl/ethanol, through its antioxidant, anti-inflammatory role, and suppression of NF-κß and MPO activities.

Maresin 1 alleviates dextran sulfate sodium-induced ulcerative colitis by regulating NRF2 and TLR4/NF-kB signaling pathway.

OBJECTIVE: Ulcerative colitis (UC) is one of the most common gastrointestinal diseases, characterized as a chronic, relapsing inflammation that causes damage to the colonic mucosa. Maresin 1 (MaR1), a specialized proresolving mediator, has powerful anti-inflammatory activity that prevents the occurrence of various inflammatory diseases. The aim of this study was to explore the role and potential mechanism of MaR1 in DSS-induced ulcerative colitis. METHODS: In the present study, we established dextran sulfate sodium (DSS)-induced ulcerative colitis rat model in vivo. Rats with colitis received tail vein injection of MaR1, with or without intraperitoneal injection of ML385. The changes of body weight, colon length, disease activity index (DAI), colonic histopathology, inflammatory cytokines, the activity of myeloperoxidase (MPO) and reactive oxygen species (ROS), and infiltration of macrophages expressing F4/80 were analyzed for the evaluation of colitis severity. In addition, protein expressions were detected using western blot. RESULTS: MaR1 significantly reduced inflammatory cytokines production, and restored body weight, DAI and colonic histopathology. Besides, MaR1 improved the expression of tight junction (TJ) proteins and reduced the infiltration of neutrophil and macrophages, as well as a decreased activity of MPO and ROS. Meanwhile, MaR1 activated Nrf2 signaling and decreased toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB) activation. Furthermore, ML385, an inhibitor of Nrf2, significantly reversed the protective effect of MaR1. CONCLUSION: MaR1 play a protective role in DSS-induced colitis by activating Nrf2 signaling and inactivating Nrf2-mediated TLR4/NF-κB signaling pathway, which mediate proinflammatory mediators and intestinal TJ proteins in rats, providing novel insights into the therapeutic strategy of colitis.

Efficacy of electrical stimulation for treatment of migraine.

BACKGROUND: The objective of this study is to assess the efficacy of electrical stimulation (ES) for the treatment of patients with migraine. METHODS: MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus, Web of Science, Allied and Complementary Medicine Database, ProQuest Nursing and Allied Health, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched for eligible studies. All electronic databases will be searched from inception to the present with no language restriction. Two authors will independently carry out study selection, data collection, and study quality assessment, respectively. RevMan 5. 3 software will be used for statistical analysis. RESULTS: This study will summarize high quality evidence on the efficacy and safety of ES for the treatment of migraine. CONCLUSION: This study will establish the accurate results of ES for migraine to facilitate the clinical practice and guideline development. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019147480.