Objective:To investigate the distribution of Traditional Chinese Medicine (TCM) syndromes in older adult patients with pneumonia who face nutritional risks, malnutrition, sarcopenia, and frailty, as well as the extent to which these syndromes affect their nutritional status.Methods:This study used a cross-sectional research design. A total of 1 263 older adult patients with pneumonia who received treatment at the Department of Traditional Chinese Medicine, The Second Hospital of Tianjin Medical University, from July 2021 to July 2024 were included in this study. These patients underwent TCM syndrome differentiation and nutritional assessments. The top 10 distribution patterns of TCM syndromes related to nutritional risk, malnutrition, sarcopenia, and frailty were identified. Logistic regression analysis was performed to analyze the effect of each syndrome pattern on nutritional risk, malnutrition, sarcopenia, and frailty. The odds ratio ( OR) value was used as the effect indicator of effect, with an OR > 1 indicating that the syndrome pattern is a risk factor for nutritional status; the larger the value, the higher the risk. Results:In older adults with pneumonia, the TCM syndrome patterns most commonly associated with nutritional risk, malnutrition, sarcopenia, and frailty were concentrated in phlegm-damp accumulation, phlegm-heat obstructing the lung, qi and blood deficiency, qi deficiency with blood stasis, qi and yin depletion, yang deficiency with water retention, spleen-stomach deficiency, lung qi depletion, and kidney deficiency with failure to grasp qi. Qi deficiency with blood stasis ( OR = 3.70) and qi and blood deficiency ( OR = 4.90) were risk factors for malnutrition. Phlegm-damp accumulation ( OR = 3.46), qi deficiency with blood stasis ( OR = 3.87), and qi and blood deficiency ( OR = 4.52) were risk factors for sarcopenia. Phlegm-damp accumulation ( OR = 2.63), phlegm-heat obstructing the lung ( OR = 3.14), qi deficiency with blood stasis ( OR = 5.78), and qi and blood deficiency ( OR = 6.33) were risk factors for frailty. Conclusions:Phlegm-dampness accumulation, phlegm-heat obstructing the lungs, deficiency of both qi and blood, and qi deficiency with blood stasis are all risk factors for nutritional risks, malnutrition, sarcopenia, and frailty in older adults. Patients with pneumonia exhibiting these patterns should pay special attention to their nutritional status, and early nutritional intervention should be implemented to prevent adverse clinical outcomes.

Objective:To investigate the distribution of Traditional Chinese Medicine (TCM) syndromes in older adult patients with pneumonia who face nutritional risks, malnutrition, sarcopenia, and frailty, as well as the extent to which these syndromes affect their nutritional status.Methods:This study used a cross-sectional research design. A total of 1 263 older adult patients with pneumonia who received treatment at the Department of Traditional Chinese Medicine, The Second Hospital of Tianjin Medical University, from July 2021 to July 2024 were included in this study. These patients underwent TCM syndrome differentiation and nutritional assessments. The top 10 distribution patterns of TCM syndromes related to nutritional risk, malnutrition, sarcopenia, and frailty were identified. Logistic regression analysis was performed to analyze the effect of each syndrome pattern on nutritional risk, malnutrition, sarcopenia, and frailty. The odds ratio ( OR) value was used as the effect indicator of effect, with an OR > 1 indicating that the syndrome pattern is a risk factor for nutritional status; the larger the value, the higher the risk. Results:In older adults with pneumonia, the TCM syndrome patterns most commonly associated with nutritional risk, malnutrition, sarcopenia, and frailty were concentrated in phlegm-damp accumulation, phlegm-heat obstructing the lung, qi and blood deficiency, qi deficiency with blood stasis, qi and yin depletion, yang deficiency with water retention, spleen-stomach deficiency, lung qi depletion, and kidney deficiency with failure to grasp qi. Qi deficiency with blood stasis ( OR = 3.70) and qi and blood deficiency ( OR = 4.90) were risk factors for malnutrition. Phlegm-damp accumulation ( OR = 3.46), qi deficiency with blood stasis ( OR = 3.87), and qi and blood deficiency ( OR = 4.52) were risk factors for sarcopenia. Phlegm-damp accumulation ( OR = 2.63), phlegm-heat obstructing the lung ( OR = 3.14), qi deficiency with blood stasis ( OR = 5.78), and qi and blood deficiency ( OR = 6.33) were risk factors for frailty. Conclusions:Phlegm-dampness accumulation, phlegm-heat obstructing the lungs, deficiency of both qi and blood, and qi deficiency with blood stasis are all risk factors for nutritional risks, malnutrition, sarcopenia, and frailty in older adults. Patients with pneumonia exhibiting these patterns should pay special attention to their nutritional status, and early nutritional intervention should be implemented to prevent adverse clinical outcomes.

Objective To explore whether glutamine can ameliorate oxidative stress injury in mice with sepsis in order to provide an experimental basis for clinical application.Methods Thirty 5-week old Qunming male mice were randomly divided into three groups: control, model and glutamine groups, 10 mice in each group. Lipopolysaccharide (LPS) 5 mL/kg was injected into intraperitoneal cavity to establish septic model in model and glutamine groups, and an equal amount of normal saline was injected into the cavity in control group. After the septic model was successfully established, propylene ammonia acyl-glutamine 0.75 g/kg was immediately injected through tail vein in the glutamine group, and an equal amount of sterile normal saline was injected into the vein in the model and control groups. After 6 hours, the experiment was terminated, the blood was collected from the orbital cavity and the animal was sacrificed; serum, liver and renal tissue homogenates were taken to detect the indexes of oxidative stress, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and lipid metabolite malonaldehyde (MDA).Results Compared with the control group, the levels of SOD activities and GSH-Px of serum and liver, kidney tissue in the model group were significantly lower, and the MDA content was significantly higher. Compared with the model group, the levels of SOD activities and GSH-Px of serum and liver, kidney tissue in the glutamine group were significantly higher, and the MDA content was significantly lower [SOD in the serum (U/mL): 134.78±3.74 vs. 124.60±3.49, SOD in the liver (U/mg): 56.71±1.35 vs. 49.84±0.86, SOD in the kidney (U/mg): 46.22±1.22 vs. 43.22±1.52; GSH-Px in serum (U/mL): 325.15±21.86 vs. 267.04±13.5, GSH-Px in liver (U/mg): 91.35±1.59 vs. 83.40±1.33, GSH-Px in kidney (U/mg): 136.08±0.58 vs. 132.97±0.74; MDA in serum (μmol/L): 9.20±0.32 vs. 13.67±1.24, MDA in liver (nmol/mg): 1.85±0.10 vs. 4.88±0.17, MDA in kidney (nmol/mg): 2.47±0.12 vs. 3.52±0.27, allP < 0.01].Conclusion Sepsis can cause oxidative stress and oxidative damage, glutamine not only can improve the levels of antioxidant enzymes of GSH-Px and SOD, enhance antioxidant capacity, reduce the MDA content of lipid metabolites, but also can reduce the toxic metabolites, so as glutamine has the effect of ameliorating oxidative stress injury.

Objective To conduct an investigation on diabetes nutrition knowledge, attitude and practice in outpatients with type 2 diabetes, understand the nutritional knowledge and dietary behaviors in patients with type 2 diabetes to guide individualized nutrition education. Methods The diabetes nutrition Knowledge, Attitude and Practice(KAP) questionnairewas designed based onChinese dietary guidelines (2007)andChinese diabetes medical nutrition therapy guidelines (2013). Data of out-patients with type 2 diabetes from January to March 2015 were collected. The method of investigation was face-to-face interview. Results Totally 915 patients were enrolled into this survey(male 495 and female 420). The mean BMI was (27.23 ± 3.18)kg/m2, glycosylated hemoglobin A1c (HBA1c) was (8.03 ± 2.17)%. Among the questions on knowledge, only on 4 questions the rate of awareness was over 80%, and there was a misunderstanding on diet, only 54.10%of diabetes patients believed that diabetes diet should be balanced and reasonable, rather than just limiting staple food and meat. Patients generally could realize the importance of diet for diabetes treatment. For questions on practice, the rate of reaching the standard generally was not over 80%. The rate of correct answers was not significantly different among different age groups, gender, and durations. There was a linear correlation between the rate of correct answers and glycosylated hemoglobin (P=0.043), the correlation coefficient was-0.258. The higher the rate of correct answers, the lower the level of glycosylated hemoglobin. Conclusion Outpatients with type 2 diabetes had good awareness level about diabetic nutritional knowledge and attitude but the awareness level of balanced diet needs to improve, the awareness rate on behavior was relatively low.

Objective To systematically review the effect of ω-polyunsaturated fatty acids-supplemented nutrition support on the immune function and nutritional status of patients with gastrointestinal malignancies.Methods Databases of MEDLINE,EMBASE,Cochrance Central register of controlled trials,China National Knowledge Infrastructure (CNKI),China Biology Medicine disc (CBM) were searched.The search words were omega-3 polyunsaturated fatty acids,fish oil,cancer,turmor,neoplasms in English or Chinese.All the high quality randomized controlled trials were included after assessed with Jadad scale.RevMan 5.2 was used for statistical analysis.Results Altogether 12 studies were included.Meta-analysis results showed that CD4+％ (I2 =0％,95％ CI=3.44～6.93,Z=5.82,P＜0.00001),CD8+％ (I2 =0％,95％ CI=2.44～7.13,Z=4.00,P＜0.000 1),CD4+％/CD8+％ (I2 =74％,95％ CI=0.16～0.83,Z=2.87,P=0.004),IgA (I2=14％,95％ CI=0.21 ～0.43,Z=5.84,P＜0.00001),prealbumin (I2 =0％,95％CI =0.02 ～ 0.05,Z =3.94,P ＜ 0.000 1) in the treatment group were higher than in the control group,C-reactive protein (I2 =76％,95％ CI =-21.33 ～-5.03,Z =3.17,P =0.002) in the treatment group was lower than in the control group,the differences were all statistically significant.But there were no statistically significant differences in CD3 + ％ (I2 =0％,95％ CI =-3.50 ～ 2.56,Z =0.31,P =0.76),IgG (I2 =92％,95％ CI=-0.32 ～5.54,Z=1.74,P=0.08),IgM (I2 =99％,95％ CI=-0.52～1.89,Z=1.11,P=0.27),total protein (I2 =0％,95％CI=-4.08 ～1.77,Z=0.78,P=0.44),albumin (I2 =29％,95％ CI=-0.87 ～1.45,Z=0.49,P=0.63),transferrin (I2 =0％,95％ CI=-0.23～0.19,Z =0.19,P =0.85) between treatment and control groups.Conclusion Omega-3 polyunsaturated fatty acids can improve the perioperative immune function of patients with gastrointestinal malignant tumor,reduce inflammatory and stress reactions,but have no obvious effect on the improvement of the nutritional status.