Nutritional assessment of elderly Japanese nursing home residents of differing mobility using anthropometric measurements, biochemical indicators and food intake

Background: Awareness and evaluation of individual nutritional status are required for optimal support of the elderly population. A Japanese Anthropometric Reference Data ( JARD 2001) was established as a new gold standard, however, its utility for very frail elderly with differing mobility and the relationship with biochemical parameters and food intake remains unclear. The purpose of this study was to investigate the possible relationship between nutritional status and mobility deficits in Japanese nursing home residents, and to compare the ability of JARD 2001 to detect malnutrition with other indicators. Methods: In 130 Japanese nursing home residents (26 men, 104 women; mean age 82.2 ± 9.0 years), anthropometric measurements (body mass index, mid‐arm circumference, triceps skinfold thickness and calf circumference), serum markers (albumin, total protein, prealbumin, retinol binding protein, total cholesterol, HDL‐cholesterol, triglyceride, white blood cells, erythrocyte, hemoglobin and lymphocytes) and food intake were assessed. The nutritional indicators were compared among categories according to severity of mobility deficits, and the ability to detect malnutrition was examined in each parameter. Results: The bedridden elderly had significantly lower nutritional indicators, including anthropometric indexes, albumin, HDL‐cholesterol and food intake, compared with other elderly who can move with or without a wheelchair. When protein‐energy malnutrition was defined as below 1.2 g/kg/day protein intake, 36.7% of the residents were considered to have an intake deficiency. The JARD 2001 was better able to identify the deficiency than albumin level in the independent and the chair‐bound, while albumin could detect the malnourished subjects more sensitively than anthropometric measurements in the bedridden. Conclusion: Poor nutritional indicators could relate with mobility deficits among institutionalized Japanese frail elderly. The ability of indicators to detect malnutrition diverged with the severity of mobility deficits. The JARD 2001 criteria should be adopted for the elderly with at least an ability to move about by wheelchair, and appropriate anthropometric reference standards for very frail people must be reconsidered.     

A prospective study of 728 cases of non-Hodgkin lymphoma from a single laboratory in Shanghai,China

The frequency of subtypes of lymphoid neoplasms was determined in a prospective series of 831 patients presenting at 29 Shanghai hospitals over a 4-year period. Diagnosis and classification was established in a single laboratory according to the 2001 WHO classification system. The frequency of non-Hodgkin lymphoma was 87.6% (n = 728) and Hodgkin lymphoma was 12.4% (n = 103). The most prevalent NHL subtypes diagnosed using WHO criteria were diffuse large B cell lymphoma (DLBCL), precursor B lymphoblastic leukemia/lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Although a low incidence has been reported in some Asian populations, CLL/SLL was commonly encountered, indicating that chronic lymphoid neoplasms are not rare in Shanghai. Consistent with previous reports, our findings indicate a decrease in the frequency of follicular lymphoma and an increase in T cell neoplasms compared to the West. Precursor T lymphoblastic leukemia/lymphoma, anaplastic large T cell lymphoma, aggressive NK cell leukemia, angioimmunoblastic T cell lymphoma and peripheral T cell lymphoma were prominent subtypes of T cell NHL.     

葡聚糖蓝2000标记五积散对鼠胃排空及小肠推进功能的影响

以葡聚糖蓝２０００作为胃肠道标记物观察中药方剂五积散对小鼠胃肠运动功能的影响。结果，五积散有明显促进胃排空及小肠推进功能的作用，与西沙必利（Ｃｉｓａｐｒｉｄｅ）效果相近。提示五积散可作为胃肠运动功能促进药用于胃肠动力障碍性疾病。未实验还证明，葡聚糖蓝２０００作为一种新的标记物，在研究药物对动物胃肠运动功能影响方面较为理想。     

利用PASS2000估计临床试验期中分析效能及样本大小

目的：介绍统计软件包PASS2000在临床试验期中分析中的应用。方法：结合不同分析模块中各功能键及选项的含义说明该软件的功能。结果：通过具体实例分析说明其应用，其计算结果与当前通用方法结果一致。结论：该软件使用简单，结果准确、可靠，值得进一步推广、应用。     

简易公共卫生地理信息系统的建立

目的：提出一个建立简易公共卫生地理信息系统的解决方法。方法：利用常规计算机软硬件及Epi Info2000／2002流行病学统计分析软件可以建立一套简易公共卫生地理信息系统。结果：使用该方法建立的简易公共卫生地理信息系统基本满足应用要求，并可节约大量经费。结论：尽可能地利用现有资源和免费资源，开源节流是基层卫生信息工作的有效方法。     

血站实验室质量管理体系内部审核结果的分析

目的：为验证实验室目前的运作与认可标准《检测和校准实验室能力的通用要求》（GB／T15481—2000）的符合性，评价质量管理体系的有效性和可靠性。方法：通过分析2004—2006年度内审中发现的不符合项在不同部门和不同要素的分布情况，以及分析不符合项的性质和不符合项的纠正措施完成情况，从而评价实验室质量管理体系运行状况。结果：2004—2006年内审发现的不符合项分别为26项、22项和10项；不符合项主要分布在研究所、办公室、质管办和检验科等；不符合项涉及的要素主要有设备管理、记录控制、设施与环境控制、文件控制和人员管理等；实施性不符合项和效果性不符合项分别有48项（82．76％）和10项（17．24％），未发现有体系性不符合项；不符合项的纠正措施基本落实完成。结论：实验室的运作符合认可标准GB／T15481—2000的要求，实验室质量管理体系运行是有效和可靠的。     

Effects of DDT and dieldrin on intestinal glucose transport and brush border hydrolases: A comparison with phenobarbital and methylcholanthrene

The enhancement of in vitro small intestinal transcellular glucose transport in NMRI mice after oral administration of the organic pesticides 2,4-DDT and dieldrin can be shown to be due to an increased active transport at the site of the brush border membrane. Intestinal disaccharidase activities were concomitantly elevated in the dieldrin group, while DDT produced no effects with intestinal hydrolases. The classic enzyme inducing agents phenobarbital and methylcholanthrene failed to stimulate intestinal glucose transport, although both increased intestinal disaccharidase activities considerably, thus questioning a close relation between these digestive and absorptive functions in the translocation of glucose. Intestinal alkaline phospatase activity was enhanced after DDT, dieldrin and methylchol-anthrene treatment, but not with phenobarbital. It is suggested that DDT and dieldrin exert their stimulating effect on intestinal glucose transport by a mechanism different from general induction of metabolic pathways.     

The antifertility and antiadrenergic actions of thiocarbamate fungicides in laying hens

The effects of the thiocarbamate fungicides, thiram, ziram, ferbam, maneb, and zineb, on norepinephrine synthesis by laying hens were investigated. Inhibition experiments with dopamine beta-hydroxylase purified from chicken adrenals indicated that thiram, ziram, and ferbam are potent competitive inhibitors with the substrate the substrate ascorbate. Maneb and zineb were without effect at comparable concentrations. Experiments investigating the interaction of thiram, ziram, and ferbam with cupric ions suggested that these compounds probably inhibit the enzyme by complexing the fully oxidized copper at its active site. Maneb and zineb also complexed cupric ions in solution and thus their failure to inhibit is not due to their inability to complex copper. When tested in vivo, thiram, ziram, and ferbam at po doses of 2.5 mg/kg or greater significantly reduced the conversion of radioactive dopa, given systemically, to brain norepinephrine. Since they did not affect the uptake of radioactive dopa by the brain or its subsequent decarboxylation within the brain to yield dopamine, these three compounds inhibit cerebral dopamine beta-hydroxylase in vivo. In contrast maneb and zineb at a po dose of 20 mg/kg had no significant effect on brain norepinephrine synthesis. Previously published results (Weppelman et al., Biol. Reprod. 23, 40-46, 1980) demonstrated that thiram, ziram, and ferbam (but not maneb or zineb) have antifertility action in laying hens. The correlation between this action and inhibition of dopamine beta-hydroxylase suggests that the antifertility effects of thiram, ziram, and ferbam might result from their antiadrenergic action. The observation that all doses of thiram in the diet which caused significant antigonadal action when fed to laying hens for 1 week also significantly decreased central and peripheral stores of norepinephrine supports this conclusion.     

Regulation of energy metabolism by creatine in cardiac and skeletal muscle cells in culture

Cardiac and skeletal muscle cells grown in culture were used in experiments designed to test the regulatory function of creatine. An increased concentration of intracellular phosphorylcreatine resulted from the addition of creatine to the growth media and the addition of metabolic inhibitors prevented the new high steady state concentration without depletion of ATP. With 1-fluoro-2, 4-dinitrobenzene the high concentration of phosphorylcreatine remained unchanged, while ATP was depleted. The use of the inhibitors provided additional evidence for creatine as the effector molecule in a feedback regulation of energy production, and for phosphorylcreatine in the regulation of energy charge at the contractile site. The effect of creatine on the fusion of myoblasts into myotubes supported its role in the control of cellular functions other than those involved in the energy metabolism. The correlation of the growth of muscle with increased muscular activity might be mediated through creatine, the end product of muscle activity. Creatine, synthesized in tissues other than muscle, might be involved in the coordination of muscle development throughout the body. Furthermore, it is suggested that the metabolic regulatory function of creatine is limited to the cells which do not synthesize creatine de novo, while in the tissues, such as the liver and kidney which have the mechanism for de novo synthesis of creatine, the absence of mitochondrial CPK precludes metabolic regulation of ～ P synthesis by creatine.     

Hydroxyproline excretion in urine of smokers and passive smokers

Urinary hydroxyproline excretion was investigated in 125 male cigarette smokers, 194 male pipe and/or cigar smokers, and 24 male nonsmokers. Hydroxyproline excretion was calculated either as hydroxyproline/creatinine ratio or as body surface-standardized amounts of hydroxyproline excreted in urine sampled during day, during night, or over 24 hr. The association of hydroxyproline excretion with smoke uptake variables such as daily cigarette consumption, carboxyhemoglobin, serum cotinine, and nicotine in urine and with self-reported passive smoking exposure in nonsmokers was analyzed. The hydroxyproline/creatinine ratio was found to be unsuitable as a measure of hydroxyproline excretion since creatinine urine concentrations correlate inversely with smoke uptake in cigarette and pipe/cigar smokers. The amount of hydroxyproline excreted in 24-hr urine and standardized for body surface was not significantly associated with smoke uptake in pipe/cigar smokers or exposure to passive smoking in nonsmokers. In cigarette smokers the situation appeared similar, although the results were less clear-cut. The data do not favor the premise that measuring urinary hydroxyproline excretion is an accurate method of investigating a lung-damaging effect of smoking, passive smoking, or air pollution.