Evaluation of high protein intake to improve clinical outcome and nutritional status for patients with burns: a systematic review

Background and aimPatients with severe burns undergo a local and systemic response to the injury. As part of this response the patient becomes hypermetabolic. Current guidelines advise high protein intakes to counteract the catabolic response to burns, but this appears to be based on minimal experimental evidence. Hence the aim of this review was to examine the evidence for improvements in nutritional status and clinical outcome with the administration of high protein intakes for patients with burns.MethodsEight databases were searched for clinical trials with burn patients receiving two or more levels of protein intake at or above the level recommended for healthy individuals (0.75 g/kg/d) and presenting results for at least one of the following pre-defined outcomes: nitrogen balance, length of stay, weight change, survival, physical therapy index, protein fractional synthetic rate, immunological measurements, bacteraemic days, systemic antibiotic days and net protein synthesis.ResultsSix studies were included, 4 of which were randomized trials. All had major methodological limitations, in particular none was blinded. There was too much heterogeneity in study design, patient characteristics and the timing and magnitude of the interventions to justify formal meta-analysis. There was no reliable evidence of improvement in nitrogen balance, but there was some evidence of increased weight gain on higher protein diets. One small study reported an increase in survival and significant improvements in infection rates and some indicators of immune function in children. Length of stay was not significantly improved. There was weak evidence of an improvement in muscle strength and endurance but no significant increase in protein synthesis in muscle or skin, or net protein synthesis in the whole body.ConclusionThere is currently only very weak evidence to justify administering high protein diets to patients following burns.     

重庆市孕前生殖健康与出生结局队列：设计简介与建设概况

出生队列是研究生命早期暴露对健康结局影响的重要工具, 但目前缺乏有力支撑孕前暴露特别是父系暴露对生殖健康和妊娠结局影响研究的大型队列平台。重庆市孕前生殖健康与出生结局队列研究是起始于孕前阶段, 同等关注男女双方的环境、心理、行为等暴露因素对生殖健康和不良妊娠结局影响的前瞻性队列研究。项目于2019年正式启动, 计划招募有生育意愿的育龄夫妇20 800人。通过随访, 调查志愿者2年内是否自然受孕。对进入妊娠期的女性志愿者, 在孕早、中、晚期进一步随访, 并对分娩的子代随访至2岁, 监测早产、低出生体重、出生缺陷、神经功能发育障碍等结局发生情况。各阶段分别采集相应的数据信息和生物样本, 包括精液、外周血、尿液、胎盘、脐带、脐带血、口腔拭子等。截至2022年1月, 已纳入志愿者8 698人, 分布于重庆市所有38个区/县。本队列建设目标是成为涵盖父母双方的前瞻性大样本孕前出生队列, 将以独特的设计和更加全面的视角阐明全生育周期特别是孕前期暴露因素对生殖健康和不良出生结局的影响及机制。     

肌肉注射维生素D3对哮喘儿童血清25-羟基维生素D的影响

目的:探讨儿童哮喘在吸入沙美特罗替卡松同时一次性肌肉注射维生素D37.5 mg治疗前后血清25-羟基维生素D[25(OH)D]的变化。方法:选取2012年10月至2014年6月在成都市妇女儿童中心医院哮喘门诊就诊的哮喘急性发作初治患儿69例,采用随机数字表法分为对照组36例和观察组33例。两组均给予沙美特罗替卡松每次一吸(50μg/100μg),2次/天;观察组仅第1天加用维生素D330万IU肌肉注射一次。两组均在治疗前及治疗3个月后取静脉血清采用化学发光法测定25(OH)D水平。结果:观察组治疗后血清25(OH)D水平升高,虽未达到理想水平,但可纠正哮喘患儿存在的25(OH)D不足或缺乏,与治疗前比较差异有统计学意义(P<0.05);对照组治疗前后血清25(OH)D水平比较差异无统计学意义(P>0.05);治疗后观察组血清25(OH)D水平高于对照组(P<0.05)。结论:对哮喘患儿给予一次性维生素D330万IU肌肉注射可以纠正其存在的25(OH)D不足或缺乏,可能是改善哮喘患儿临床预后的积极补充治疗措施。     

Impact of hepatitis B virus infection on maternal and infant outcomes of women with gestational diabetes mellitus: A three-year retrospective study

AimsTo explore the impact of HBV infection on maternal and infant outcomes of GDM women.MethodsWe retrospectively identified 8126 women with GDM in China from July 2017 to June 2020, and divided them into GDM with HBV infection group (n = 483) and GDM with non-HBV infection group (n = 7643). Two sample t-test and Chi-square test were used to compare differences between groups. Logistic regression models were used to explore the association between HBV infection and maternal and infant outcomes.ResultsPlacental abruption (PA), (2.3% vs. 1.0%, P = 0.008), placenta previa (4.3% vs. 2.8% p = 0.044), intrahepatic cholestasis of pregnancy (ICP), (6.4% vs. 3.0%, P < 0.001), cesarean section (52.0% vs. 46.0%, P = 0.011), fetal chromosomal abnormalities (1.2% vs. 0.4%, P = 0.021), and neonatal hyperglycemia (1.9% vs. 3.6%, P = 0.047) were more likely to occur in GDM with HBV infection group. After adjusting for the covariates, HBV infection was found to be associated with ICP (aOR, 2.35; 95% CI: [1.58–3.50]), PA (aOR, 2.34; 95% CI: 1.22–4.47), and fetal chromosomal abnormalities (aOR, 2.88; 95% CI: 1.18–7.03).ConclusionsHBV infection was associated with part of maternal and infant outcomes in the GDM population.     

Alterations in Gut Vitamin and Amino Acid Metabolism are Associated with Symptoms and Neurodevelopment in Children with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - Metabolic disturbance may be implicated in the pathogenesis of autism. This study aimed to investigate the gut metabolomic profiles of autistic...     

A allele of SNP12 in <Emphasis Type="Italic">estrogen receptor 1</Emphasis> was a risk factor for cryptorchidism in Asians: a systematic review with meta-analysis and trial sequential analysis

Objective

Some studies have been carried out to evaluate the association between SNP12 in estrogen receptor 1 and cryptorchidism, but the results remain inconsistent. We carried out a meta-analysis to explore the association between this polymorphism and cryptorchidism risk.

Methods

All eligible studies were searched in PubMed, Web of Science, Embase and Cochrane Library. Pooled odds ratios, with 95 % confidence intervals, were assessed for the association using fixed- and random-effects models.

Results

Overall, four case–control studies (363 cases, 415 controls) were included in the meta-analysis. No significant publication bias (P _Begg = 0.308, P _Egger = 0.288) was found. A allele of SNP12 in estrogen receptor 1 was protective factor to cryptorchidism in allele model, dominant genetic model and heterozygote comparison in Caucasians, but the result was turned out to be false positive by trial sequential analysis. However, A in allele model was risk factor to cryptorchidism in Asians (odds ratio 2.02, 95 % confidence interval 1.03–3.01, p = 0.946 for heterogeneity) and the result was turned out to be true positive by trial sequential analysis, even though there were merely two original studies.

Conclusions

The results of this meta-analysis suggest that A allele of SNP12 in estrogen receptor 1 may increase the risk of cryptorchidism in Asians. Meanwhile, further well-designed studies with large sample sizes are required to confirm the present findings, especially in Caucasians.

     

儿童典型失神发作和不典型失神发作的临床特征及文献复习

目的:总结并比较儿童典型失神(TAS)发作和不典型失神(AAS)发作的临床特点、治疗及预后。方法:收集失神发作性癫痫患儿临床资料37例,其中TAS组19例,AAS组18例,并进行随访。结果:TAS组起病年龄3.7~10.2岁,4~10岁起病17例,占89.5%,无神经系统发育及头颅影像学检查异常,有特征性脑电图改变,治疗完全控制率为83.3%。AAS组66.7%合并其他发作形式,神经系统发育及头颅影像学检查异常分别为55.6%和43.8%,脑电图改变多样,治疗完全控制率为33.3%。两组治疗完全控制率比较差异有统计学意义(P<0.05)。结论:TAS起病与年龄相关,多无神经系统发育及检查异常,且有特征性的脑电图改变,预后良好;AAS发病年龄差异大,多有神经系统发育及检查异常,预后较差。