1.Impact of short-term omega-3 fatty acids supplementation on clinical outcomes in postoperative patients with parenteral nutrition support: a Meta-analysis of randomized controlled trials
Yanwu ZHANG ; Zhuming JIANG ; Yang WANG ; Mingwei ZHU ; Yan WANG
Chinese Journal of Clinical Nutrition 2011;19(4):213-221
ObjectiveTo evaluate the impact of omega-3 fatty acids intervention on clinical outcomes in postoperative patients with parenteral nutrition (PN). MethodsLiteratures relating to the evaluation of the clinical outcomes after supplementation with omega-3 fatty acids after selective surgeries were searched in databases including PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Databases, China National Knowledge Infrastructure, and Wanfang Database etc. All the eligible studies were randomized controlled trials and their results were published from January 1996 to June 2010. The methodological quality was assessed using Jadad scale, Schulz allocation concealment tool, and methodology review. Meta analysis was conducted using RevMan 5.1 software. The impact was described in terms of complications of infection, case-fatality rate, length of postoperative hospital stay, and length of postoperative ICU stay. ResultsTotally 320 articles were found and 17 randomized controlled trials ( n =1213 ) entered final meta analysis study. The results showed a significant decrease in the infectious complication rates of postoperative patients receiving omega-3 fatty acids intervention [risk ratio (RR) =0.44, 95% confidence interval (CI) (0.30, 0.64), P <0.0001] ; meanwhile, the length of hospital stay was significantly shortened [mean difference (MD) =- 1.65 ; 95% CI ( - 2.72, - 0.58), P =0.003]. However,the length of ICU stay showed no significant difference [MD =-0.31,95% CI ( - 1.20, 0.58), P =0.500].ConclusionOmega-3 fatty acids interventions can benefit postoperative patients by reducing the morbidity of postoperative infectious complications and shortening the length of hospital stay.
2.The difference of mixing time and contamination rate between liquid and powder preparations EN
Xiurong, WANG ; Zhuming, JAING ; Baogui, WANG ; Yujian, NIU
Chinese Journal of Clinical Nutrition 2000;8(1):35-36
Objective To wmpare the differences of the mixing time and contamination rate between liquid and powder EN preparations. Methods 20 patients,receiving enteral nutrition for more than 6 days, were enrolled in. this study. They were randomized to receive either powder enteral diet (control group, n=10) or liquid enteral diet (study group, n=10). The mixing time was examed by stopwatch. The contamination rate was determined by culture of bacteria in the solution. Results 1. The mixing time of study group was significantly shorter than that of control group ( 18.9 ± 3.0 vs 106.0 ± 21.0 , P<0. 001). 2. The bacterial culture in both groups were negative before enteral feeding. There was no positive case in study group and only 2 positive eases in control group after infusion. However, there was no statistical difference between the two groups ( P=0.14). Conclusions Liquid form of enteral nutfitent was less time cost and no ease contaminated by enveriorment, but it is expensive. he ligurd preparation has more advantages than powdor one in mixing time and comtamination.
3.Application of self care interactive mode in clinical nursing of patients with thoracolumbar fracture
Yunxian FU ; Yaling ZHU ; Fei WANG ; Manfei QIAN ; Zhuming KONG
Chinese Journal of Primary Medicine and Pharmacy 2016;23(10):1483-1488
Objective To explore the influence of self care interaction mode on the health behavior of the patients with thoracolumbar fracture.Methods 127 cases of thoracolumbar fracture were randomly divided into the observation group (62 cases)and the control group (65 cases)according to random digital table method.The patients of the observation group were given self nursing interactive nursing.The patients of the control group were given rou-tine nursing.The comparative study of the following indicators of the two groups of patients:(1)activities of daily liv-ing (ADL);(2)bedridden patient self -care skills of and self -care knowledge assessment;(3)satisfaction,compli-cations,the average length of days and discharged patient telephone visit the initiative.Results The discharge self nursing ability raise,health behavior change,self -care knowledge and self -care skills of the observation group were significantly better than the control group,there were statistically significant differences(P <0.05);after discharge from the hospital,bed incidence of complications (6.5%)of the observation group was significantly lower than the control group (18.1%),the difference was statistically significant (χ2 =4.16,P <0.05)and satisfaction degree (91.7 ±6.5)was higher than the control group (87.3 ±7.5),with statistically significant difference (t =3.59,P <0.05),and the average hospitalization day (16.11 ±7.61 )d was lower than that of the control group (19.95 ± 11.55)d,there was statistically significant difference (t =2.20,P <0.05).Conclusion Self care interactive mode is conducive to mining the self -care ability of patients,improve the self -care ability of patients,and has good social benefits.
4.The effect of Aescin on chronic venous insufficiency:a randomized controlled multi-center clinical trial
Guoxiang DONG ; Zhonggao WANG ; Faqi LIANG ; Chunqi ZHAO ; Zhuming JIANG
Chinese Journal of General Surgery 1997;0(04):-
0.05). Body weight, blood pressure, blood routine test and blood biochemical parameters did not change in the two groups. Only mild side reactions of aescin was found and there was no dropout in the study group, whereas 7 patients dropped out in the control group due to the intolerance for the pressure. Conclusion Aescin has similar efficacy and fewer side effects compared with the compression stocking method in the treatment of chronic venous insufficiency.
5.Quality evaluations for five published meta-analyses of intravenous fish oil interventions on clinical outcomes by a measurement tool to assess systematic reviews
Yanwu ZHANG ; Zhuming JIANG ; Siyan ZHAN ; Yang WANG
Chinese Journal of Clinical Nutrition 2013;21(6):329-332
Objective To use a measurement tool to assess systematic reviews (AMSTAR) to assess the methodological quality of published meta-analyses of intravenous fish oil interventions on clinical outcomes in postoperative or intensive care unit (ICU) patients supported with parenteral nutrition (PN).Methods PubMed,EMBASE,Cochrane Library,Web of Science,Chinese Biomedical Databases,China National Knowledge Infrastructure,Wanfang Database,and some other databases were searched to retrieve the eligible studies published from January 1996 to September 2013,and the relevant journals and the references of included studies were also retrieved manually.The studies were included if they were systematic reviews or meta-analyses that evaluated the effects of fish oil-enriched PN and standard PN for postoperative or ICU patients on clinical outcome.Two reviewers screened the literature according to the inclusion criteria and extracted the data.Then the AMSTAR was used to evaluate the quality of the included studies.Results A total of five relevant meta analyses were included.Based on AMSTAR,two studies were of high quality,one of moderate quality,and the other two were of low quality.Conclusions The methodological quality of these five published metaanalyses of intravenous fish oil interventions is uneven.Further large-scale and high-quality randomized controlled trials about the impact of intravenous fish oil on clinical outcomes and cost-effectiveness analysis for postoperative and ICU patients are needed.
6.Translational medicine related tools for quality assessments of clinical trials and the trial reports
Yanwu ZHANG ; Zhuming JIANG ; Yang WANG ; Bin ZHANG ; Tiejun HU
Chinese Journal of Clinical Nutrition 2011;19(1):1-6
Objective and fair clinical trials are the main methods for assessing the clinical significances of the experimental findings. The development of translational medicine highly relies on high-quality clinical trials as well as trial reports. Although the definition of"quality of clinical trials"and"quality of trial reports"differs from each other, they are closely related and can be consistent in most circumstance in the context of"scientific integrity". The quality of trial reports can be basically assessed by their internal and external properties. The quality of a randomized trial can be assessed by Jadad scale and Cochrane collaboration's tool for assessing risk of bias, and the quality of a non-randomized trial by risk of bias tool and Newcastle-Ottawa scale. However, since Jadad scale lacks appropriate appraisal of allocation concealment and is too simple in evaluating blind method, assessment of allocation concealment should be added. A more widely accepted approach for assessing the quality of random trials is the combination of Jadad scale and Schulz's approach to allocation concealment till recent years.For non-randomized cohort studies and case-control studies, Newcastle-Ottawa scale might be suitable at present time.
7.Effects of hypocaloric parenteral nutrition on metabolism and prognosis of aged post-traumatic patients, a randomized controlled study
Mingwei ZHU ; Junmin WEI ; Xiurong WANG ; Zhuming JIANG
Chinese Journal of Geriatrics 2001;0(03):-
Objective To evaluate the effects of hypocaloric parenteral nutrition on metabolism and prognosis of aged post-traumatic patients. Methods The prospective randomized controlled study was designed. Twenty-four aged post-operative patients were divided into 2 groups: hypocaloric parenteral nutrition group (Caloric 15 kcal?kg -1?d -1/Nitrogen 0.1 g?kg -1?d -1 ) and traditional parenteral nutrition (Caloric 28 kcal?kg -1?d -1/Nitrogen 0. 2 g?kg -1?d -1), respectively. Serum glucose, protein, and lipid levels, infection-related complications, nutrition therapy hospital expenses, hospitalization duration after operation were analysed. Results During nutritious fluid transfusion at 1-5 days after operation, nutrition therapies, serum glucose level of hypocaloric group was obviously lower than that of the traditional group 〔(6.8?0.3) mmol L -1 vs (8.3?0.4) mmol?L -1 , P
8.A prospective and descriptive study on the nutritional risks, undernutrition, and application of nutritional support among inpatients with later but non-end-stage cancer in a Beijing-based second grade hospital
Xiaoqin ZHANG ; Yang WANG ; Hong WANG ; Jiayi LI ; Kang YU ; Xiaotian ZHANG ; Zhuming JIANG
Chinese Journal of Clinical Nutrition 2014;22(1):28-33
Objective To investigate prospectively the nutritional risks,undernutrition,and nutritional support in hospitalized patients with later but non-end-stage malignancies in a second grade hospital in Beijing.Methods All patients who were admitted in the department of oncology in this hospital from October 2011 to April 2013 were consecutively recorded.Nutritional Risk Screening (NRS 2002) was used for screening nutrition risks,the undernutrition assessment was performed on the first morning for patients meet the inclusion criteria,and nutritional support was evaluated until the discharge.For patients with no nutritional risk,NRS 2002 was repeated weekly during the hospitalization.Results A total of 305 cases of inpatients admitted,and 224cases meeting the inclusion criteria were screened by NRS 2002,among whom only 171 patients with non-endstage later stage cancer entered the final analysis.Among these 171 patients,116 (67.8%) were at nutritional risks.Furthermore,for different types of tumor,the nutritional risk was 45.7% for lung cancer,89.4% for digestive-tract cancers,81.3% for liver-biliary and pancreatic cancers,and 83.3% for head-and-neck cancers.The undernutrition rate was 12.3% (21/171) if based on body mass index < 18.5 kg/m2 and 19.9% (34/171) if evaluated from the score of nutritional defect part of NRS 2002.Only 71 patients (61.2%) at nutritional risk received nutritional support,while 5 of 55 patients (9.1%) without nutritional risk received nutritional support.The average ratio of parenteral nutrition to enteral nutrition was 23∶ 1.Intravenous calories intake was 56.78 ± 8.20 k J/ (kg · d) ; the intake of nitrogen was 0.06 ± 0.01 g/ (kg · d),and the ratio of calories to nitrogen was 204∶ 1.Conclusions A large proportion of inpatients with non-end-stage later cancer were at nutritional risk,which is associated with tumor types.The application of nutritional support should be further standardized,particularly for patients at nutritional risk but with low nutritional support.Furthermore,whether the clinical outcome of inpatients at nutritional risk may be improved by nutritional support still requires further investigation.
9.Impact of nutrition support on clinical outcomes for the patients with gastrointestinal disease at nutritional risk by Nutrition Risk Screening 2002 tool and the preliminary finding of cost-effectiveness analysis: a prospective cohort study for 275 patien
Yan WANG ; Zhuming JIANG ; Kondrup JENS ; Yang WANG ; Nolan MARIE ; Jiaming QIAN ; Kang YU
Chinese Journal of Clinical Nutrition 2013;21(6):333-338
Objective To evaluate the impact of nutrition support on the clinical outcomes of gastrointestinal disease patients at nutritional risk and explore the the cost-effectiveness of various nutrition support options.Methods A prospective cohort study was designed.The patients who met the predetermined inclusion criteria were followed up during the hospital stay.Nutritional risk was determined using the Nutrition Risk Screening 2002 on admission.The information with respect to nutritional support,occurrence and treatment of complications,length of hospital stay,and discharge destination was monitored and recorded.The direct costs of nutritional support and the costs of diagnosing and treating complications were calculated after discharge.Infectious complication-free patient was used as the effectiveness indicator in the cost-effectiveness analysis.Results Patients who had received nutrition support had significantly lower infectious complications incidence (6.8% vs.19.6%,x2 =9.0,P=0.003) and significantly higher total hospitalization costs (P =0.0001).The adjusted (by general linear model) cost of parenteral nutrition (PN) cohort,enteral nutrition (EN) cohort,PN combined EN cohort,and the cohort without nutritional support were 5635,1212,5220,and 1339 China Yuan,respectively.The incremental cost effectiveness ratios were 36 101,-794,and 33 748 China Yuan for PN,EN,and PN-EN combination groups,respectively.Conclusions For the patients at nutritional risk,nutritional support can remarkably reduce the incidence of infectious complications.The preliminary resuits of cost-effectiveness:due to lack of enough data required by health economic professional,it can not be cited directly.
10.Effects of Anti Idiotypic Antibody NP30 on Modulation of Egg Granuloma Formation and Hepatic Fibrosis of Schistosomiasis *
Zhenqing FENG ; Rong ZHU ; Yuhua LI ; Zhenning QIU ; Yunqian LI ; Zhuming WANG ; Wanfen XUE ; Xiaohong GUAN ;
Chinese Journal of Parasitology and Parasitic Diseases 1987;0(01):-
Objective To study the effects of the monoclonal anti idiotypic antibody NP30 active immunization on egg granuloma formation and hepatic fibrosis in Schistosoma japonicum infection. Methods ICR mice were actively immunized with NP30 100 ?g ?3 ip. every 10 days while the mice in control group were injected with SP2/0 ascites ip. simultaneously. After cercariae challenging,the mice were killed at the 4th, 8th,12th, 16th, 20th and 24th week, respectively.Mouse livers were removed and stained histochemically with VG and subjected to immunohistochemical assay of collagen type Ⅰ,Ⅲ and fibronectin(FN).The volume of egg granulomas and the content of collagen type Ⅰ,Ⅲ and FN were determined quantitatively by NYD 1000 Image Analysis System. Results The volume of egg granulomas in NP30 immunized group was much smaller than that of control group from the 12th week after cercariae challenge. The cellular components of egg granulomas in NP30 immunized group were significantly different from those of the control group,exhibiting two types of atypical egg granulomas were found.VG stain revealed that the average optical density of collagen in hepatic granulomas of experimental group was lower than that of control group.Immunohistochemical assay revealed that the contents of collagen type Ⅰ,Ⅲ and fibronectin in egg granulomas of experimental group were lower than those of control group. Conclusion NP30 vaccination may induce both cellular and humoral protective immunity to modulate egg granulomas and suppress liver fibrosis of schistosomiasis japonica.