Objective:To investigate the accuracy of resting energy expenditure(REE)prediction formulas and to develop a new REE prediction formula suitable for hospitalized older adults.Methods:Older adults hospitalized in the Department of Geriatrics from October 1, 2022, to November 31, 2022, were included in the study.The predicted values of REE(pREE)were estimated using 13 commonly employed formulas that incorporate parameters related to resting energy expenditure, such as gender, age, body mass index(BMI), and body weight.Indirect calorimetry measurements(mREE)served as the gold standard for comparison.Group differences between pREE and mREE, the coefficient of concordance( ICC), and accuracy(defined as±10% of the mREE values)were utilized to evaluate the performance of the formulas.The ten-fold cross-validation method was employed to identify valid variables and to construct a new prediction formula.The performance of this new formula was compared to mREE, the Harris-Benedict formula, the European Society of Clinical Nutrition and Metabolism(ESPEN)formula, and the Chinese Society of Clinical Nutrition and Metabolism(CSPEN)formula. Results:A total of 223 hospitalized participants aged 60 to 98 years(mean age 79.5±8.2 years)were included in the study.Among these participants, 49.3%(110 cases)were male, and the prevalence of frailty was approximately 84.3%(188 cases).The median difference between pREE and mREE ranged from 9.1 to 232.1 kcal/d.The predictions from the Harris-Benedict, ESPEN, and CSPEN equations differed significantly from mREE(all P<0.05), with respective accuracies of 30.9%, 31.4%, and 24.7%.A new equation was developed: pREE=794.847+ 8.661×body weight -7.976 × age+ 14.757 ×grip strength+ 5.037 × heart rate, with an ICC of 0.6(95% CI: 0.5-0.7), and the accuracy reached 56.3%. Conclusions:Existing equations demonstrate low accuracy in predicting REE among hospitalized older adults.The newly developed equation shows improved performance compared to previous models and can serve as a reference method for predicting REE in this demographic.

Objective:To investigate the accuracy of resting energy expenditure(REE)prediction formulas and to develop a new REE prediction formula suitable for hospitalized older adults.Methods:Older adults hospitalized in the Department of Geriatrics from October 1, 2022, to November 31, 2022, were included in the study.The predicted values of REE(pREE)were estimated using 13 commonly employed formulas that incorporate parameters related to resting energy expenditure, such as gender, age, body mass index(BMI), and body weight.Indirect calorimetry measurements(mREE)served as the gold standard for comparison.Group differences between pREE and mREE, the coefficient of concordance( ICC), and accuracy(defined as±10% of the mREE values)were utilized to evaluate the performance of the formulas.The ten-fold cross-validation method was employed to identify valid variables and to construct a new prediction formula.The performance of this new formula was compared to mREE, the Harris-Benedict formula, the European Society of Clinical Nutrition and Metabolism(ESPEN)formula, and the Chinese Society of Clinical Nutrition and Metabolism(CSPEN)formula. Results:A total of 223 hospitalized participants aged 60 to 98 years(mean age 79.5±8.2 years)were included in the study.Among these participants, 49.3%(110 cases)were male, and the prevalence of frailty was approximately 84.3%(188 cases).The median difference between pREE and mREE ranged from 9.1 to 232.1 kcal/d.The predictions from the Harris-Benedict, ESPEN, and CSPEN equations differed significantly from mREE(all P<0.05), with respective accuracies of 30.9%, 31.4%, and 24.7%.A new equation was developed: pREE=794.847+ 8.661×body weight -7.976 × age+ 14.757 ×grip strength+ 5.037 × heart rate, with an ICC of 0.6(95% CI: 0.5-0.7), and the accuracy reached 56.3%. Conclusions:Existing equations demonstrate low accuracy in predicting REE among hospitalized older adults.The newly developed equation shows improved performance compared to previous models and can serve as a reference method for predicting REE in this demographic.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

In this study, the critical quality attributes of Wuzhuyu Decoction reference sample were explored by using characteristic chromatogram, index component content and dry extract rate as indexes.The dissemination relationship of quantity value between medicinal materials-decoction pieces-reference sample was investigated to preliminarily formulate the quality standard of the reference sample.The characteristic chromatogram of 15 batches of Wuzhuyu Decoction was established by high performance liquid chromatography(HPLC) and the similarity analysis was conducted.Common peaks were demarcated and assigned to medicinal materials.Moreover, quantitative determination of limonin, evodiamine, rutaecarpine and ginsenoside Rb_1 of Wuzhuyu Decoction were performed.The dissemination of quantity value was explored combined with dry extract rate, similarity of characteristic chromatogram and transfer rate of index component content.A total of 18 common peaks were identified in the corresponding materials of Wuzhuyu Decoction reference sample, with the similarity of characteristic chromatogram greater than 0.9, and Fructus Evodiae, Radix Ginseng, Rhizoma Zingiberis Recens and Fructus Jujubae contributed 9, 5, 8 and 2 chromatographic peaks, respectively.The index component content of corresponding materials and the transfer rates of medicinal materials-decoction pieces and decoction pieces-reference sample of different batches of Wuzhuyu Decoction reference sample were as follows: the content of limonin was 0.16%-0.51%, and the transfer rates were 83.66%-115.60% and 38.54%-54.58%, respectively; the content of evodiamine was 0.01%-0.11%, the transfer rated were 80.80%-116.15% and 3.23%-12.93%, respectively; the content of rutaecarpine was 0.01%-0.05%, the transfer rates were 84.33%-134.53% and 5.72%-21.24%, respectively; the content of ginsenoside Rb_1 was 0.06%-0.11%, and the transfer rates were 90.00%-96.92% and 32.45%-67.24%, respectively.The dry extract rate of the whole prescription was 22.58%-29.89%.In this experiment, the dissemination of quantity value of Wuzhuyu Decoction reference sample was analyzed by the combination of characteristic chromatogram, index component content and dry extract rate.A scientific and stable quality evaluation method of the reference sample was preliminarily established, which provided basis for the subsequent development of Wuzhuyu Decoction and the quality control of related preparations.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Ginsenosides/analysis* ; Limonins/analysis* ; Quality Control

Background: Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study. Methods: TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54). Results: Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning. Conclusions: Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China. Trial Registration ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.
China ; Crotonates ; administration & dosage ; adverse effects ; therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Multicenter Studies as Topic ; Multiple Sclerosis ; drug therapy ; metabolism ; Proportional Hazards Models ; Toluidines ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVETo evaluate surgical outcomes and the feasibility of robotic thyroidectomy and central neck dissection (CND).

METHODSThe clinical data of 40 patients of papillary thyroid microcarcinoma underwent total thyroidectomy (or lobectomy and isthmusectomy) and CND using the Da Vinci system through axillo-bilateral-breast approach in Jinan Military General Hospital of People's Liberation Army from February to December 2014 were analyzed retrospectively (robotic group). Other forty patients of papillary thyroid microcarcinoma underwent total thyroidectomy (or lobectomy and isthmusectomy) and CND by open approach were selected as the control (open group). Cosmetic satisfaction was assessed after a month postoperation by the numerical score system. t-test and χ(2) test were used to compare the clinical characters, total operative time, intraoperative estimated blood loss, postoperative hospital stay, number of lymph nodes removed, visual analogue scale for pain, postoperative complications, and cosmetic effect between the 2 groups.

RESULTSAll 80 patients were diagnosed of papillary thyroid microcarcinoma. The total thyroidectomy (or lobectomy/isthmusectomy) with CND of 40 patients were successfully performed by da Vinci Si surgical system. The numbers of total thyroidectomy of robotic group and the open group were 36 and 37, respectively. The numbers of metastatic lymph nodes of robotic group and open group were 14 and 15, respectively. The operation time of the robotic group was (130±12) minutes, which was longer than that of open group (98±11) minutes (t=12.432, P<0.05). The study showed statistical significant difference between the two groups regarding the visual analog scale pain assessment (1.9±0.9 vs.3.9±1.1, t=8.900, P<0.05). There were no statistical significant difference of intraoperative estimated blood loss, postoperative hospital stay, number of lymph nodes removed, and the complication rate between the 2 groups.Postoperative cosmetic result was more satisfying on the robotic group (9.1±0.5) than open group (4.8±1.5) (t=17.200, P<0.05).

CONCLUSIONSThe robotic total thyroidectomy (or lobectomy and isthmusectomy) and CND has similar surgery safety and feasibility as open procedures. The robotic thyroidectomy is a good alternative surgical modality for patients with papillary thyroid microcarcinoma who wish to avoid neck scars.

Axilla ; Breast ; Carcinoma, Papillary ; surgery ; Humans ; Length of Stay ; Lymph Nodes ; Neck Dissection ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Robotic Surgical Procedures ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods

BACKGROUNDA large proportion of the patients with papillary thyroid microcarcinoma are young women. Therefore, minimally invasive endoscopic thyroidectomy with central neck dissection (CND) emerged and showed well-accepted results with improved cosmetic outcome, accelerated healing, and comforting the patients. This study aimed to evaluate the safety and effectiveness of robotic total thyroidectomy with CND via bilateral axillo-breast approach (BABA), compared with conventional open procedure in papillary thyroid microcarcinoma.

METHODSOne-hundred patients with papillary thyroid microcarcinoma from March 2014 to January 2015 in Jinan Military General Hospital of People's Liberation Army (PLA) were randomly assigned to robotic group or conventional open approach group (n = 50 in each group). The total operative time, estimated intraoperative blood loss, numbers of lymph node removed, visual analog scale (VAS), postoperative hospital stay time, complications, and numerical scoring system (NSS, used to assess cosmetic effect) were analyzed.

RESULTSThe robotic total thyroidectomy with CND via BABA was successfully performed in robotic group. There were no conversion from the robotic surgeries to open or endoscopic surgery. The subclinical central lymph node metastasis rate was 35%. The mean operative time of the robotic group was longer than that of the conventional open approach group (118.8 ± 16.5 min vs. 90.7 ± 10.3 min, P < 0.05). The study showed significant differences between the two groups in terms of the VASs (2.1 ± 1.0 vs. 3.8 ± 1.2, P < 0.05) and NSS (8.9 ± 0.8 vs. 4.8 ± 1.7, P < 0.05). The differences between the two groups in the estimated intraoperative blood loss, postoperative hospital stay time, numbers of lymph node removed, postoperative thyroglobulin levels, and complications were not statistically significant (all P > 0.05). Neither iatrogenic implantation nor metastasis occurred in punctured porous channel or chest wall in both groups. Postoperative cosmetic results were very satisfactory in the robotic group.

CONCLUSIONSRobotic total thyroidectomy with CND via BABA is safe and effective for Chinese patients with papillary thyroid microcarcinoma who worry about the neck scars.

Adult ; Carcinoma, Papillary ; blood ; surgery ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Neck Dissection ; Operative Time ; Postoperative Period ; Robotic Surgical Procedures ; methods ; Thyroglobulin ; blood ; Thyroid Neoplasms ; blood ; surgery ; Thyroidectomy ; methods

Aged ; Animals ; Female ; Follow-Up Studies ; Humans ; Influenza A Virus, H7N9 Subtype ; pathogenicity ; Influenza, Human ; pathology ; virology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Aneurysm, False ; etiology ; surgery ; Blood Loss, Surgical ; Carcinoma ; Carotid Arteries ; Carotid Artery Diseases ; etiology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Rupture