Objective To evaluate the effect of nutrition support on nutritional status and clinical outcome of patients at nutritional risk in internal medical departments.Methods 148 patients at nutritional risk as identified by Nutritional Risk Screening 2002 were numbered according to the order of admission and divided into standard care group (control group,odd numbers,n =75) and individualised nutrition support group (intervention group,even numbers,n =73).Intervention consisted of encouraging food intake,designing food plan,and assuring implementation of food prescription.Energy and protein intake,body weight,length of hospital stay,hospitalization expenses and complications were compared between the two groups.Results In the interventions group,protein intake was significantly higher than that in the control group [(45.1 ± 2.2) g/d vs.(54.8±2.5) g/d,P=0.004],and energyintake higher than that in the control group [(4 180.0± 227.4) kJ/d vs.(4 589.6 ± 150.5) kJ/d,P =0.135] but without statistical significance.Intervention led to an intake of ≥75％ of requirements in 46.6％ patients in the intervention group,significantly higher than the proportion in the control group (30.7％) (P =0.047).The change of body weight was significantly smaller in the intervention group than in the control group [(-0.4 ± 0.2) kg vs.(-1.1 ± 0.2) kg,P =0.025].The length of hospital stay,hospitalization expenses,and incidence of complications showed no significant differences between the control group and the intervention group [(13.5 ±0.9) d vs.(12.4 ±0.6) d,P=0.310;(17834±1824) yuanvs.(16099±1243) yuan,P=0.435;12.8％ vs.8.1％,P=0.184].Conclusions Patients at nutritional risk in internal medical departments could benefit from nutrition support in terms of protein intake and body weight maintenance.A large-scale randomized controlled trial is necessary to confirm the effect of nutrition support on clinical outcomes of patients at nutritional risk.

Teaching of clinical practice is the most important part of education of Tradi-tional Chinese Medicine(TCM).We plan to make clinical rotation internships,standardize the whole process of internships,standardized management of clinical teaching,in order to achieve our objectives of TCM Clinical teaching.We hope to guide the medical students to link theory with clinical practice during clinical rotation internships,set up clinical thinking of intern,and practice the basic skills and operating specifications of intern.

OBJECTIVETo establish the quality standards of Linmaoxiang Jiedu pills.

METHODCinobufagin and bufogenin were determined by HPLC simultaneously.

RESULTThe average recoverys of Cinobufagin and bufogenin was 100.5% and 100.3%, their linear range were 48.74-731.10 ng and 49.90-748.50 ng, respectively.

CONCLUSIONThe method for quantification is reproducible and realizable. The method can be used to control quality of Linmaoxiang Jiedu pills as the quality standards.

Objective To investigate the relationship between glucokinase regulator protein ( GCKR) gene polymorphism rs780094 and hyperuricemia in Uygur in Xinjiang. Methods A case-control study including 1 026 patients with hyperuricemia and 1 030 normal subjects was conducted. All the subjects were genotyped for GCKR gene rs780094 by Sequenom MassARRAY system. The results of rs780094 genotype and allele frequency between hyperuricemia group and control group were compared. The associations of different genotypes of rs780094 with blood pressure, blood lipid, and blood glucose were analyzed. Logistic regression analysis was used to analyse the relationship between polymorphism of rs780094 and hyperuricemia in Uygur in Xinjiang. Results The distributions of three genotypes(G/G, A/G, A/A) and two allele frequency (G and A) in GCKR rs780094 revealed statistical difference ( P<0. 05 ) between hyperuricemia group and control group. A tendency toward association with hyperuricemia was observed under dominant model(OR=1. 295, 95%CI 1. 078~1. 554,P=0. 006) and recessive model(OR=1. 284, 95% CI 1. 024 ~1. 611,P=0. 030). The levels of systolic blood pressure, diastolic blood pressure, and total cholesterol were lower in hyperuricemia group with GCKR gene rs780094 loci GG genotype than those with AA+AG genotype. After adjusting confounding factors which had significant difference in the single factor analysis, logistic regression analysis showed that rs780094 A/A and A/G might be risk factors of hyperuricemia in Uygur in Xinjiang (OR=1. 355,95% CI 1. 094 ~1. 679,P=0. 005). Conclusion The GCKR rs780094 is associated with hyperuricemia in Uygur in Xinjiang. The A/A and A/G genotype of the GCKR rs780094 may increase the risk of hyperuricemia.

The expression levels of serum tenascin-C, osteopontin(OPN), and transforming growth factor-β1(TGF-β1) in the patients of diabetic mellitus were measured by ELISA. With the increase of the UACR, the expression of tenascin-C, osteopontin, and transforming growth factor-β1 showed a trend of increase and hypertension will argument this phenomenon. Pearson correlation analysis showed that levels of tenascin-C were positively correlated with HbA1C , body mass index, systolic blood pressure, diastolic blood pressure, UACR, osteopontin, and transforming growth factor-β1.

Objective To explore the effect of hospital-community integration follow-up pattern on medication compliance in patients with mental disorder. Methods From January 2016 to January 2017, 96 patients were treated effectively with systemic therapy in psychosomatic department and TCM WM department, and 96 discharged mental disorder patients were treated with brief psychiatric rating scale (BPRS) ≤ 28. The patients were randomly divided into 48 cases in the intervention group and the control group; both groups were standardized medication; control group received an outpatient referral, intervention group combined with medical doctors in our hospital and community doctors for one year follow-up intervention. Observed the condition of illness and medication compliance after six months and one year intervention between two groups, compared the patient recurrence rate of one year after discharge. Results BPRS score of intervention group was significantly lower than control group (P＜0. 01), the difference was statistically significant, while intervention group had higher compliance than control group (P＜0. 01), and the difference was statistically significant. Recurrence rate (20. 83％) of intervention group was significantly lower than control group (38. 78％) ( 2 = 4. 03, P＜0. 05), the difference was statistically significant. Conclusion Hospital-community integration follow-up has positive effect on stabilizing patients with mental disorder and improving compliance and decreasing relapse rate.

Objective To investigate the influence of serum cystatin C(Cys-C)and hypersensi-tivity C-reactive protein(hs-CRP)levels on the 3-year survival of patients undergoing maintenance he-modialysis(MHD).Methods A total of 358 patients with chronic renal failure who underwent MHD at the Second Affiliated Hospital of Nantong University from April 2011 to October 2020 were selected as study subjects.General clinical data,pre-dialysis laboratory test indicators,and echocardiographic indicators 3 months after dialysis were recorded.The survival status of patients after 3 years of dialysis was followed up,and the general clinical data,pre-dialysis laboratory test indicators,and echocardio-graphic indicators 3 months after dialysis were compared between surviving and deceased patients.Un-ivariate and multivariate Cox regression analyses were performed to screen influencing factors of 3-year survival in MHD patients.Results At the 3-year follow-up,of the 302 MHD patients'203 survived,and 99 died.Statistically significant differences were observed in age,primary disease,diabetes sta-tus,congestive heart failure,statin use,antiplatelet drug use,diuretic use,dialysis mode,esti-mated glomerular filtration rate(eGFR)and gamma-glutamyl transferase(GGT),alkaline phospha-tase(AKP),total bilirubin(TBIL),β2-microglobulin(β2-MG),creatinine(Cr),low-density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),and serum phos-phorus(P)levels between surviving patients and deaths(P＜0.05 or P＜0.01).Univariate Cox regression results showed that age of MHD patients,primary disease(diabetic nephropathy,hyper-tensive nephropathy,polycystic kidney disease,others),comorbidities(diabetes,congestive heart failure,other cardiovascular diseases),drug use(statins,antiplatelet drugs),dialysis method(he-modialysis,hemodialysis+perfusion),laboratory test indicators[GGT,AKP,TBIL,total bile acid(TBA),albumin(ALB),Cr,Cys-C,eGFR,apolipoprotein A(APO-A),hs-CRP]were all influential factors of 3-year survival rate of MHD patients.Multivariate Cox regression analysis re-vealed that age,primary disease,other cardiovascular diseases,dialysis mode,AKP,ALB,TBIL,Cys-C,and hs-CRP were significant influencing factors for the survival of patients with chronic renal failure(P＜0.05).Conclusion Serum Cys-C and hs-CRP levels before MHD in patients with chronic renal failure may be associated with their 3-year survival after dialysis treatment.High serum Cys-C may reduce the risk of poor clinical prognosis,while high serum hs-CRP may increase the risk of poor clinical prognosis.

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*

Objective To investigate the influence of serum cystatin C(Cys-C)and hypersensi-tivity C-reactive protein(hs-CRP)levels on the 3-year survival of patients undergoing maintenance he-modialysis(MHD).Methods A total of 358 patients with chronic renal failure who underwent MHD at the Second Affiliated Hospital of Nantong University from April 2011 to October 2020 were selected as study subjects.General clinical data,pre-dialysis laboratory test indicators,and echocardiographic indicators 3 months after dialysis were recorded.The survival status of patients after 3 years of dialysis was followed up,and the general clinical data,pre-dialysis laboratory test indicators,and echocardio-graphic indicators 3 months after dialysis were compared between surviving and deceased patients.Un-ivariate and multivariate Cox regression analyses were performed to screen influencing factors of 3-year survival in MHD patients.Results At the 3-year follow-up,of the 302 MHD patients'203 survived,and 99 died.Statistically significant differences were observed in age,primary disease,diabetes sta-tus,congestive heart failure,statin use,antiplatelet drug use,diuretic use,dialysis mode,esti-mated glomerular filtration rate(eGFR)and gamma-glutamyl transferase(GGT),alkaline phospha-tase(AKP),total bilirubin(TBIL),β2-microglobulin(β2-MG),creatinine(Cr),low-density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),and serum phos-phorus(P)levels between surviving patients and deaths(P＜0.05 or P＜0.01).Univariate Cox regression results showed that age of MHD patients,primary disease(diabetic nephropathy,hyper-tensive nephropathy,polycystic kidney disease,others),comorbidities(diabetes,congestive heart failure,other cardiovascular diseases),drug use(statins,antiplatelet drugs),dialysis method(he-modialysis,hemodialysis+perfusion),laboratory test indicators[GGT,AKP,TBIL,total bile acid(TBA),albumin(ALB),Cr,Cys-C,eGFR,apolipoprotein A(APO-A),hs-CRP]were all influential factors of 3-year survival rate of MHD patients.Multivariate Cox regression analysis re-vealed that age,primary disease,other cardiovascular diseases,dialysis mode,AKP,ALB,TBIL,Cys-C,and hs-CRP were significant influencing factors for the survival of patients with chronic renal failure(P＜0.05).Conclusion Serum Cys-C and hs-CRP levels before MHD in patients with chronic renal failure may be associated with their 3-year survival after dialysis treatment.High serum Cys-C may reduce the risk of poor clinical prognosis,while high serum hs-CRP may increase the risk of poor clinical prognosis.

Solar energy, which is essential for the origin and evolution of all life forms on Earth, can be objectively recorded through attributes such as climatic ambient temperature (CAT), ultraviolet radiation (UVR), and sunlight duration (SD). These attributes have specific geographical variations and may cause different adaptation traits. However, the adaptation profile of each attribute and the selective role of solar energy as a whole during human evolution remain elusive. Here, we performed a genome-wide adaptation study with respect to CAT, UVR, and SD using the Human Genome Diversity Project-Centre Etude Polymorphism Humain (HGDP-CEPH) panel data. We singled out CAT as the most important driving force with the highest number of adaptive loci (6 SNPs at the genome-wide 1 × 10-7 level;401 at the suggestive 1 × 10-5 level). Five of the six genome-wide significant adaptation SNPs were successfully replicated in an independent Chinese population (N = 1395). The corresponding 316 CAT adaptation genes were mostly involved in development and immunity. In addition, 265 (84％) genes were related to at least one genome-wide associationstudy (GWAS)-mapped human trait, being significantly enriched in anthropometric loci such as those associated with body mass index (x2;P<0.005), immunity, metabolic syndrome, and cancer (x2;P<0.05). For these adaptive SNPs, balancing selection was evident in Euro-Asians, whereas obvious positive and/or purifying selection was observed in Africans. Taken together, our study indicates that CAT is the most important attribute of solar energy that has driven genetic adaptation in development and immunity among global human populations. It also supports the non-neutral hypothesis for the origin of disease-predisposition alleles in common diseases.