[Exploration of phase angle used to construct PG-SGA nutritional assessment and prediction model for malignant tumor patients].

Objective: To explore the value of phase angle (PA) in constructing a predictive model of nutrition evaluation for tumor patients. Methods: A retrospective analysis was performed on 1 129 patients with malignant tumors hospitalized in the Cancer Center of Changzhi People's Hospital from June 2020 to February 2021. PA values of six parts of the body were measured by the body composition analyzer, including: left arm (LA), right arm (RA), left leg (LL), right leg (RL), the trunk (TR), and the whole body (WB). Patients' body mass index (BMI) was calculated and patient-generated subjective global assessment (PG-SGA) was assessed. The differences of PA values of six parts were compared and their correlations with BMI and PG-SGA in combination with age, gender and tumor disease types were analyzed, binary classification regression on BMI and PG-SGA was performed, and the functions of the best prediction model was fitted. Decision tree, random forest, Akaike information criterion in a Stepwise Algorithm (stepAIC) and generalized likelihood ratio test were used to select appropriate variables, and the logit logistic regression model was used to fit the data. Results: Comparing the PA values of six parts in pairs, it was found that the PA values of LA and RA, LL and RL, and TR and WB were linearly correlated and the coefficient was close to 1 (P<0.001). Binary classification regression was performed for BMI and PG-SGA, respectively. In order to make the data have clinical significance, 18.5 kg/m(2) was used as the classification point for BMI, 4 and 9 were used as the classification points for PG-SGA score, and the models of A, B and C were obtained. Suitable variables including PA-LA, PA-TR and tumor disease types were used as variables to fit BMI classification; BMI, PA-LA and age were used as variables to fit the PG-SGA model with 9 as the classification point. PA-LA, PA-TR, BMI, age and tumor disease types were used as variables to fit the PG-SGA model with 4 as the classification point. In this study, the predicted values of models A, B and C obtained by R-studio were imported into SPSS 26.0 software, and the cut-off values of classification were obtained by the receiver operating characteristic (ROC) curve. The ROC analytic results showed that the best cut-off values of Model A, B and C were 0.155, 0.793 and 0.295. Model A recommended when the probability is >0.155, a patient's nutritiond tatus should be classified as BMI < 18.5 kg/m(2) group. Model B recommended that PG-SGA<9 group be classified as the probability is >0.793. Model C recommended that PG-SGA < 4 group should be classified when probability is >0.295. Conclusions: The PG-SGA classification prediction model is simple to operate, and the nutritional status of patients can be roughly divided into three groups: normal or suspected malnutrition group (PG-SGA<4), moderate malnutrition group (4≤PG-SGA<9), and severe malnutrition group (PG-SGA≥9). This model can more efficiently predict the nutritional status of cancer patients, greatly simplify the nutritional assessment process, and better guide the standardized treatment of clinical malnutrition.

Financial burden on the families of patients with hepatitis B virus-related liver diseases and the role of public health insurance in Yunnan province of China.

OBJECTIVE: To investigate the financial burden of patients who had various stages of hepatitis B virus-related diseases and the level of alleviation from financial burden by health insurance schemes in Yunnan province of China. STUDY DESIGN: A cross-sectional survey. METHODS: Patients' information was consecutively recorded at the First Affiliated Hospital of Kunming Medical University, from December 2012 to June 2013. Consecutive cases of hepatitis B virus (HBV) (520), compensated cirrhosis (91), decompensated cirrhosis (198) and hepatocellular carcinoma (HCC) (131) were recruited from the outpatient and inpatient departments. The total direct costs, hospital charge, outpatient costs, hospitalization fees being reimbursed and household catastrophic health expenditure were estimated for each disease group. RESULTS: The average annual direct costs for each disease group were 19,496 RMB for HBV, 28,466 RMB in compensated cirrhosis, 46,061 RMB for decompensated cirrhosis, and 33,044 RMB for HCC patients. Catastrophic health expenditure occurred in all four groups. Health insurance reimbursement released the financial burden incurred by medical expenses of patients under a high level of household economic status. Public health insurance schemes helped the patients to various extents. CONCLUSIONS: Among these patient groups, direct costs represent a significant economic burden. Health expenditure and financing systems must be considered to prevent the increase of household catastrophe, particularly among the poor.

Gas chromatograph-surface acoustic wave for quick real-time assessment of blood/exhaled gas ratio of propofol in humans.

BACKGROUND: Although pilot studies have reported that exhaled propofol concentrations can reflect intraoperative plasma propofol concentrations in an individual, the blood/exhaled partial pressure ratio RBE varies between patients, and the relevant factors have not yet been clearly addressed. No efficient method has been reported for the quick evaluation of RBE and its association with inter-individual variables. METHODS: We proposed a novel method that uses a surface acoustic wave (SAW) sensor combined with a fast gas chromatograph (GC) to simultaneously detect propofol concentrations in blood and exhaled gas in 28 patients who were receiving propofol i.v. A two-compartment pharmacokinetic (PK) model was established to simulate propofol concentrations in exhaled gas and blood after a bolus injection. Simulated propofol concentrations for exhaled gas and blood were used in a linear regression model to evaluate RBE. RESULTS: The fast GC-SAW system showed reliability and efficiency for simultaneous quantitative determination of propofol in blood (correlation coefficient R(2)=0.994, P<0.01) and exhaled gas (R(2)=0.991, P<0.01). The evaluation of RBE takes <50 min for a patient. The distribution of RBE in 28 patients showed inter-individual differences in RBE (median 1.27; inter-quartile range 1.07-1.59). CONCLUSIONS: Fast GC-SAW, which analyses samples in seconds, can perform both rapid monitoring of exhaled propofol concentrations and fast analysis of blood propofol concentrations. The proposed method allows early determination of the coefficient RBE in individuals. Further studies are required to quantify the distribution of RBE in a larger cohort and assess the effect of other potential factors. CLINICAL TRIAL REGISTRATION: ChiCTR-ONC-13003291.

Production and health assessment of second-generation cloned Holstein cows derived by somatic cell nuclear transfer.

In this study we evaluated cloning efficiency of second-generation (G2) cloned Holstein cows derived from ear fibroblasts of a first-generation (G1) cloned cow, and assessed their health status in terms of physical, growth and reproductive parameters. Compared with G1 cloning, G2 cloning showed a slight decrease on blastocyst rate of reconstructed embryos (30.2±5.8% vs. 28.5±7.2%, p>0.05), while the quality of its blastocysts reduced significantly (Grade 1 and Grade 2, 21.1±4.1% vs. 17.1±5.7%, p<0.05). After embryo transfer (ET), both pregnancy rate to term and calving rate of G2 cloning were approximately half of G1 cloning (5.8% vs. 10.7%; 3.9% vs. 8.6%, p>0.05). Six G2 cloned cows were delivered, and three of them survived. G2 cloned calves displayed symptoms of being overweight at birth and tachycardia in the first week after birth. During the first 12 months, the growth of G2 cloned calves was similar to control calves derived from artificial insemination (AI). Furthermore, the interindividual variation of growth within the G2 clonal family was smaller except at birth and at two months of age. Interestingly, although G2 cloned cows reached puberty 45 days later in comparison with control cows derived from AI, they were all pregnant by AI, and gave birth to healthy calves. This suggests that their reproductive performance was not affected by late puberty. In summary, our results showed that although cloning efficiency of G2 was lower than that of G1, the surviving G2 clones appeared physically healthy and were fertile.

Improved, low-cost methods for pancreatic islet purification in rats.

OBJECTIVE: Density gradient separation of islets from exocrine tissue is usually performed using Ficoll. However, this reagent significantly increases the cost of isolation. The aim of the present study was to investigate the effects on islet preparations of purification methods using Lymphoprep and Iodixanol (OptiPrep) density gradients. METHODS: Pancreata were procured from 46 Wistar rats, loaded with collagenase V (Sigma), and mechanically dissociated using standard procedures. After the digestion phase, the islets purified by 3 methods-Ficoll, Lymphoprep, and Iodixanol (OptiPrep)-were assessed for yields, purity, morphology, and in vitro function. RESULT: We expressed the yields as islet equivalents (IEQ, diameter standardizing to 150 microm), showing no significant differences. Compared with the Ficoll group, the purity was significantly higher in the Lymphoprep (P = .005) and Iodixanol (OptiPrep) groups (P = .011). While the viability was >90% in all 3 groups, the viability in the Lymphoprep Group and OptiPrep groups was significantly higher than that of the Ficoll group (P < .001). In vitro islet function did not differ among the 3 experimental groups. CONCLUSION: Lymphoprep and Iodixanol were as effective as Ficoll in terms of islet yield and in vitro function. High-purity and high-viability islet cells were obtained using improved Lymphoprep-based or Iodixanol (OptiPrep)-based density gradient methods, potential low-cost substitutes for Ficoll.

Assessment of soil lead exposure in children in Shenyang, China.

Soil lead pollution is serious in Shenyang, China. The paper brings together the soil work, the bioaccessibility, and the blood lead data to assess the soil lead exposure in children in Shenyang, China. Approximately 15.25% of the samples were above China Environment Protection Agency guideline concentration for soil Pb to protect human from health risk (350 mgkg(-1)). Pb concentrations varied among use scenarios. The main lead contamination sources are industry emission and automobile exhaust. Bioaccessibility also varied among use scenarios. Children, who ingested soil from industrial area, public parks, kindergarten playground, and commercial area, are more susceptible to soil lead toxicity. The industrial area soil samples presented higher bioaccessibility compared to the other use scenario soil samples contaminated by automobile exhaust. The result also suggested a most significant linear relationship between the level of Pb contamination and the amount of Pb mobilized from soil into ingestion juice. Soil pH seemed to have insignificant influence on bioaccessibility in the present study. Bioaccessibility was mainly controlled by other factors that are not investigated in this study. A linear relationship between children blood lead and soil intestinal bioaccessibility was present in the study. Children who are 4-5 years old are more likely to demonstrate the significant relationship between soil lead bioaccessibility and blood lead as their behaviors place them at greatest risk of soil lead toxicity, and their blood lead levels are more likely to represent recent exposure.

A comparison of 99Tcm-MIBI myocardial SPET and electron beam computed tomography in the assessment of coronary artery disease in two different age groups.

The aim of this study was to compare the clinical value of 99Tcm-MIBI single photon emission tomography (SPET) and electron beam computed tomography (EBCT) in the assessment of coronary artery disease (CAD) in different age groups. 99Tcm-MIBI SPET (stress-rest), EBCT and coronary angiography studies were performed in 64 consecutive patients with suspected CAD. The patients were classified into two groups: Group A = 40 patients > 45 years of age and Group B = 24 patients < or = 45 years of age. There were 31 and 14 patients with coronary stenosis > or = 50% as determined by coronary angiography in Groups A and B, respectively. All patients (30 cases) with abnormal 99Tcm-MIBI myocardial SPET and coronary calcification detected by EBCT had significant coronary artery disease, and 93.3% of the patients with normal 99Tcm-MIBI SPET and normal EBCT had normal coronary angiography or < 50% lumen narrowing of the coronary arteries. In Group B, the sensitivity of SPET for detecting CAD was significantly higher than that of EBCT (92.9 vs 42.9%, P < 0.01); the specificity of SPET was comparable to that of EBCT. In Group A, there was no significant difference between SPET and EBCT in terms of sensitivity (93.6 vs 90.3%) or specificity (88.9 vs 55.6%). However, in the detection of individual coronary artery disease, the specificity of SPET was significantly higher than that of EBCT in Group A (94.1 vs 66.7%, P < 0.001). The sensitivity of SPET was again significantly higher than that of EBCT (85.7 vs 38.1%, P < 0.005) in Group B. The accuracy of SPET was higher than that of EBCT in both groups (82.5 vs 67.5%, P < 0.01 in Group A; 93.1 vs 76.4%, P < 0.01 in Group B, respectively). We conclude that 99Tcm-MIBI myocardial perfusion SPET has a higher sensitivity than EBCT in the detection of CAD in patients < or = 45 years old and a higher specificity in patients > 45 years of age. A combination of SPET and EBCT may assess CAD more accurately.

Costs of polio immunization days in China: implications for mass immunization campaign strategies.

Ten provinces of China were selected to estimate the cost per immunization of the 1994-95 national immunization days (NIDs) at five levels (e.g. province, prefecture, county, township and village). Personnel costs accounted for the largest overall share of costs (39 per cent), followed by publicity and promotion costs (27 per cent), and logistic costs (15 per cent). Without consideration of vaccine costs, the major part of NID expenses were shouldered at the township level, which paid for 47 per cent of all incremental costs, while county and village level covered 28 per cent and 18 per cent respectively. Estimation of average costs per immunization was 2.86 RMB yuan, or $0.34, including vaccine costs, buildings and equipment amortization and salaries at all levels. The factors affecting average cost of NID included the output volume, socio-economic development and geographic features. Various approaches were recommended: to intensify the productivity of time and staff, to employ alternative inexpensive manpower resources, to make the best use of publicity and social promotion, the expansion of the age groups and utilization of multi-intervention strategies. Good planning at township level was a decisive factor to ensure an effective NID conducted in an efficient manner. The average cost of China's NID was the lowest among all mass immunization campaigns ever documented. Much of the reduced average cost was attributable to economies of scale.