Реферат
Objective:To explore the risk factors for malnutrition after a tracheotomy and to construct a predictive model useful for its prevention through early intervention.Methods:Clinical data describing 440 tracheotomy patients were subjected to a retrospective analysis. The variables examined were age, sex, etiology, Glasgow Coma Score (GCS), activities of daily living (ADL) score, age-corrected Charlson comorbidity index (aCCI), food intake, swallowing function, incidence of infections, as well as any history of diabetes mellitus, hypertension, smoking or alcohol consumption. Patients identified as being at risk of malnutrition (NRS-2002≥3) were screened using the Nutritional Risk Screening tool (NRS-2002) and the European Society of Clinical Nutrition and Metabolism′s ESPEN2015 criteria. The subjects were thus categorized into a malnutrition group of 343 and a control group of 97. Unifactorial and multifactorial logistic regression analyses were performed, and stepwise regression was applied to include the factors found significant in the unifactorial analysis into the multifactorial logistic regression analysis, and to construct a column-line graph prediction model. The clinical utility of the model was assessed by applying the receiver operator characteristics (ROC) curves, calibration plots and decision curve analysis (DCA).Results:Of the 440 persons studied, 343 (78%) were malnourished. The multivariate logistic regression analysis showed that pulmonary infection, dysphagia, low GCS score and high aCCI score were significant risk factors for malnutrition after a tracheotomy. A prediction nomograph was constructed. After fitting and correcting, the area under the curve (AUC) of the prediction model′s ROC curve was 0.911, the specificity was 80.4%, and the sensitivity was 91.3%. That was significantly higher than the AUCs for pulmonary infection (0.809), dysphagia (0.697), aCCI (0.721) and GCS (0.802). Bootstrap self-sampling was used to verify the model internally. After 1000 samples the average absolute error between the predicted risk and the actual risk was 0.013, indicating good prediction ability. The DCA results demonstrated that the model has substantial clinical applicability across a range of nutritional interventions, particularly for threshold probability values ranging from 0 to 0.96.Conclusion:Pulmonary infection, dysphagia, low GCS score, and high aCCI score are risk factors for malnutrition among tracheotomy patients. The nomogram model constructed in this study has good predictive value for the occurrence of malnutrition among such patients.
Реферат
Objective:To analyze the risk factors for malnutrition among disabled stroke survivors and devise a prediction model.Methods:A total of 373 disabled stroke survivors treated in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Zhengzhou University in 2021 formed a control group ( n=102) and a malnutrition group ( n=271) according to their nutritional status. Univariate correlation analysis and multivariate logistic regression were used to analyze the risk factors for malnutrition and their predictive value. Results:Age, dysphagia, pulmonary infection, disability score and feeding style were found to be related significantly to the occurrence of malnutrition. Multivariate logistic regression confirmed that age, pulmonary infection, dysphagia, low total intake and a low Barthel index were useful predictors of malnutrition in such persons. Moreover, patients who had received nasogastric tube feeding were at much higher risk of malnutrition than those with intermittent oroesophageal tube feeding. The area under the receiver operating characteristics curve of the Barthel index combined with dysphagia to predict malnutrition was 0.84. The critical value was 0.67 with a sensitivity of 88% and a specificity of 72.5%.Conclusions:Age, pulmonary infection, dysphagia, feeding method, total intake and disability score are risk factors for malnutrition in disabled stroke survivors. The Barthel index combined with dysphagia has good predictive power for the occurrence of malnutrition in such persons.
Реферат
Objective To investigate the preventive effect of treating cardiotoxicity induced by adriamycin (ADM) with the method of nourishing yin. Methods 90 cancer patients underwent adriamycin therapy were randomly recruited intoa treatment group (45 cases) and a control group (45 cases). The treatment group was treated with Wushen decoction, while the control group was treated with antioxidant drugs. The changes of ECG, blood SOD, GSH-Px, MDA content etc were observed after one course of four weeks' treatment. Results The incidence of cardiactoxicity was 15.56% in the treatment group and 40.00% in the control group, showing significant difference ( U=2.02, P<0.05 ) ; the incidence of ECG abnormalities was 13.33% in the treatment group and 37.78%, in the control group, showing significant difference (U= 2.18, P< 0.05 ) : the effective rate was 82.22% in the treatment group and 62.22% in the control group, showing significant difference ( U=2.18, P <0.05) ; and SOD, GSH-Px, MDA content at the 1, 7, 14, and 28days between the two groups also demonstrated significant differences (P<0.05) . Conclusion The method of nourishing yin has excellent attenuation to adriamycin-induced cardiotoxicity, besides it enhances therapeutic effects of chemotherapy.
Реферат
Objective To investigate nutritional support in the treatment of cancer in recent years.Methods Seperately diSCUSS on application conditions of enteral nutrition and parenteral nutrition in the treatment of cancer and its advantages and disadvantages.Results Enteral nutrition can improve digestive funcdon,reduce costs and enhance immunity.Parenmral nutrition can supplement insufficiency of enteral niltrition and inhibit tumor growth by selecting the kinds of nuWients to support a normal body function.Conclusion Enteral nutrition combined witll parenteral nutrition iS a suitable means of nutritional support in the treatment ofcancer.