腹部手术后病人辨证配膳的临床研究

目的 :运用中医理论对腹部手术后病人进行辨证配膳的临床研究 ,使病人尽早恢复正常食欲。方法 :辨证配膳的前瞻性研究 ,12 0例腹部手术病人按抽签法随机分为干预组和对照组。干预组实施个体化辨证配膳 ,对照组按医嘱指导术后饮食。结果 :干预组食欲恢复正常明显好于对照组 ,P <0 .0 1。结论 :辨证配膳可有效改善食欲 ,促进康复     

Effects of Dietary Self-Monitoring,Physical Activity,Liraglutide 3.0 mg,and Placebo on Weight Loss in the SCALE IBT Trial

IntroductionIndividuals who enroll in intensive behavioral therapy (IBT) programs are asked to make several lifestyle changes simultaneously. However, few studies have examined the relative effects of adherence to different treatment components on weight loss.ObjectiveThis secondary analysis of the SCALE IBT trial assessed adherence to the medication regimen, dietary self-monitoring, and physical activity recommendations and their relative contributions to weight change in individuals with obesity who were provided with IBT combined with either liraglutide 3.0 mg or placebo.MethodsSCALE IBT was a double-blinded, multicenter, randomized controlled trial comparing 56-week weight losses in individuals with obesity who received liraglutide 3.0 mg (n = 142) or placebo (n = 140), as an adjunct to IBT. Adherence to dietary self-monitoring, physical activity, and medication usage (liraglutide or placebo) were measured during the 56-week treatment period. A regression model was used to estimate the relative contribution of adherence to each treatment component to weight loss at week 56.ResultsThe proportion of individuals who adhered to each intervention component decreased over time. Compared with non-adherence, complete adherence to dietary self-monitoring and physical activity recommendations were associated with estimated weight changes of −7.2% (95% CI −10.4 to −4.0; p < 0.0001) and −2.0% (95% CI −3.2 to −0.8; p = 0.0009), respectively. Complete adherence to liraglutide predicted an additional weight loss of −6.5% (95% CI −10.2 to −2.9; p = 0.0005) relative to individuals who did not adhere to the medication regimen, while adherence to placebo did not have a statistically significant effect on weight loss (p = 0.33).ConclusionsHigh adherence to dietary self-monitoring and use of liraglutide 3.0 mg was associated with clinically relevant weight loss with IBT and adjunctive pharmacotherapy. The effect of adherence to physical activity was significant but smaller.     

Effect of limited access to sucrose on overeating and patterns of feeding

Four groups of adult rats, housed on a 12-12, light-dark cycle, were allowed access to a nutritionally complete diet and water. Three of these groups were also offered a 32% solution of sucrose. The sucrose was available for either the 24-hour period, the 12 hours of light or the 12 hours of dark. Access to sucrose led to overeating and excessive weight gain. These effects were more pronounced when the sucrose was available for the 24-hour period or during the dark. Limited access to sucrose produced a reversal of the rat's usual circadian pattern of feeding when the sucrose was available during the light and increased the rat's nocturnal hyperphagia when it was available during the dark. Sucrose intake and the proportion of calories taken from sucrose were higher in the 24-hour access group and the dark access group than the light access group. Access to sucrose did not induce a pattern of dietary selection that compromised growth or health. It appears that access to a palatable carbohydrate solution can lead to overeating and major changes in the circadian organization of feeding behavior. These data emphasize the potent role that external factors can play in the control of ingestive behavior.     

The sand rat (psammomys obesus) as an experimental animal in studies of diabetes mellitus

Summary The sand rat has some unique attributes, which make it a valuable experimental animal. The occurrence of increased plasma insulin levels and of hyperglycemia is linked to an increased food intake. As in the human maturity-onset type diabetes, there seems to be an element of insulin resistance, and this can be demonstratedin vitro by the relative unresponsiveness of sand rat adipose tissue to increasing doses of pork insulin. Prophylactic treatment with acetohexamide seems to have some protective effect against the diabetogenic results of a high calory diet. — It is expected that the diabetic syndrome in sand rats, which can be so easily induced by dietary manipulation, will be a valuable tool in helping to clarify some of the possible mechanisms in the syndrome of diabetes mellitus.This work was carried out during the tenure of Research Career Awards from the U. S. Public Health Service to Drs.Hackel (HE-K6-14, 188) andSchmidt-Nielsen, (K6-GM-21, 522) a Career Development Award to Dr.Lebovitz (K3-AM-17, 954), and a Research Fellowship to Dr.Horton (F3-AM-32, 326); supported by grants from the U. S. Public Health Service (AM-08949, AM-1324, and HE-0228), Eli Lilly Co., the Duke University Research Council, and the Mary Duke Biddle Foundation.     

Consenso multidisciplinar sobre la valoración y el tratamiento nutricional y dietético en pacientes con enfermedad renal crónica e infección por SARS-CoV-2. Consenso de nutrición en enfermedad renal crónica e infección por SARS-CoV-2

The presence of malnutrition in patients with chronic kidney disease (CKD) is high, it can be made worse by SARS-CoV-2 infection.The nutritional assessment should be adapted to minimize the infection, recommending monitoring: weight loss percentage, body mass index (BMI), loss of appetite, analytical parameters and functional capacity using the dynamometer. As well as the sarcopenia assessment using the SCARF scale, and the possibility of using the GLIM criteria in those patients who have been tested positive by MUST.It is important to adapt the nutritional recommendations in the caloric and protein intake, to the CKD stage and to the SARS-CoV-2 infection stage. In patients with hypercatabolism, to prioritize preserving the nutritional status (35 kcal/kg weight/day, proteins up to 1.5 g/kg/day). The rest of the nutrients will be adapted to CKD stage and the analytical values.In the post-infection stage, a complete nutritional assessment is recommended, including sarcopenia. The energy and protein requirements in this phase will be adapted to the nutritional status, with special attention to the loss of muscle mass.Dietary recommendations need to be tailored to side effects of SARS-CoV-2 infection: anorexia, dysphagia, dysgeusia, and diarrhea.Anorexia and hypercatabolism makes it difficult to meet the requirements through diet, therefore the use of oral nutritional supplements is recommended as well as the enteral or parenteral nutrition in severe phases.     

高脂高胆固醇饮食小型猪CD36表达的变化

目的:用高脂高胆固醇饮食喂养贵州小香猪，探讨高脂高胆固醇饮食小香猪清道夫受体CD36表达的变化。方法:采用高脂高胆固醇饲料喂养贵州小香猪，每2个月末称体重并从禁食过夜的小香猪眶静脉窦采集血样，检测血脂浓度。血浆总胆固醇、甘油三酯、高密度脂蛋白胆固醇的浓度均用酶法测定；采用逆转录-聚合酶链反应、蛋白质印迹和免疫组织化学分别检测CD36 mRNA和蛋白质的表达。 结果:喂养2个月后，实验组血浆总胆固醇、高密度脂蛋白胆固醇含量明显高于正常对照组；血浆甘油三酯水平从第4个月末开始升高, 在第7个月末明显增加；肝组织、胸主动脉和肾脏组织CD36表达上调，同时观察到高脂高胆固醇小型猪胸主动脉PPARγ的表达上调。 结论:提示高脂高胆固醇饲料可引起贵州小型猪的脂质代谢紊乱,并导致肝组织、胸主动脉和肾脏组织的CD36表达上调以及胸主动脉PPARγ的表达上调。     

Chandipura virus: a major cause of acute encephalitis in children in North Telangana, Andhra Pradesh, India

A hospital-based surveillance was undertaken between May 2005 and April 2006 to elucidate the contribution of Chandipura virus (CHPV) to acute viral encephalitis cases in children, seroconversion in recovered cases and to compare the seroprevalences of anti-CHPV IgM and N antibodies in areas reporting cases with those without any case of acute viral encephalitis. During this period, 90 cases of acute encephalitis were hospitalized in the pediatric wards of Mahatma Gandhi Memorial (MGM) Hospital, Warangal. There were 49 deaths (Case Fatality Rate, i.e., CFR of 54.4%). Clinical samples and records were obtained from 52 suspected cases. The cases were below 15 years, majority in 0-4 years (35/52, 67.3%). Computerized tomography (CT) scans and cerebro-spinal fluid (CSF) picture favored viral etiology. No neurological sequelae were observed. CHPV etiology was detected in 25 cases (48.1%, n = 52; RNA in 20, IgM in 3 and N antibody seroconversion in 2). JEV etiology was detected in 5 cases (IgM in 4 cases and seroconversion in 1 case). Anti-CHPV IgM seroprevalence in contacts (26/167, 15.6%) was significantly higher (P < 0.05) than in non-contacts (11/430, 2.6%); which was also observed in children <15 years (19/90, 21.1% vs. 3/109, 2.7%). Anti-CHPV N antibody seroprevalence in <15 years contacts (66/90, 73.3%) and non-contacts (77/109, 70.6%) was significantly lower (P < 0.05) than in contacts (75/77, 97.4%) and non-contacts (302/321, 94.1%) more than 15 years respectively. CHPV appears to be the major cause of acute viral encephalitis in children in endemic areas during early monsoon months.     

Effects of metabolic control, patient education and initiation of insulin therapy on the quality of life of patients with type 2 diabetes mellitus

OBJECTIVE: The objective of this study was to evaluate the impact of initiation of insulin therapy, metabolic control and structured patient education on the diabetes-related quality of life (QoL) in insulin-treated patients with type 2 diabetes mellitus. METHODS: This prospective study was conducted with 71 consecutively recruited patients with insulin-treated diabetes at the University hospital. All patients participated an inpatient diabetes treatment and teaching program (DTTP) for conventional insulin therapy (mean age 68.9 years, HbA1c 10.1+/-1.4%, diabetes duration 11.2 years (range: 0-25.5 years), body-mass-index 28.7+/-5.7kg/m(2). Diabetes-related quality of life was assessed before and 6 months after participation in the DTTP using the standardized questionnaire of Lohr analysing the subscales: social relations, physical complaints, worries about the future, dietary restrictions, fear of hypoglycaemia, and daily struggles. RESULTS: Only patients switched on insulin therapy showed significant improvement in diabetes-related quality of life 6 months after participation in the DTTP (p=0.03), fewer physical complaints (p=0.03), fewer worries about the future (p=0.02), fewer daily struggles (p=0.01) and less fear of hypoglycaemia (p<0.001), while patients, who were already on insulin therapy showed no improvements in diabetes-related quality of life. Though, residual analysis reveals that effects on patients' QoL are mainly caused by improvements in metabolic control. CONCLUSIONS: Improvements in metabolic control have a significant effect on different diabetes-related quality of life domains in patients with diabetes mellitus. PRACTICE IMPLICATIONS: Appropriate interventions resulting in better metabolic control, such as starting on insulin therapy within a structured patient education program seem to be an effective approach to improve patients' diabetes-related quality of life.