1.Comparison of three different measurement methods to determine resting energy expenditure in patients with decompensated hepatitis B cirrhosis.
Wen WANG ; Yan Hua ZHANG ; Ting Ting YANG ; Ning LI ; Qian Kun LUO ; Tao QIN ; Lei LEI
Chinese Journal of Hepatology 2023;31(1):65-69
Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People's Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.
Humans
;
Male
;
Female
;
Energy Metabolism
;
Liver Cirrhosis/metabolism*
;
Calorimetry, Indirect/methods*
;
Hospitalization
2.Effect of sedation on resting energy expenditure in patients with extremely severe burns and the choice of energy estimation formula.
Tao SHEN ; Li Ping ZHANG ; Yi Ran WANG ; Zhi Kang ZHU ; Chun Mao HAN
Chinese Journal of Burns 2022;38(8):714-721
Objective: To investigate the effect of sedation on resting energy expenditure (REE) in patients with extremely severe burns and the choice of REE estimation formula during the treatment. Methods: A retrospective non-randomized controlled clinical study was conducted. From April 2020 to April 2022, 21 patients with extremely severe burns who met the inclusion criteria and underwent mechanical ventilation treatment were admitted to the Department of Burn and Wound Repair of Second Affiliated Hospital of Zhejiang University School of Medicine, including 16 males and 5 females, aged 60 (50, 69) years. Early anti-shock therapy, debridement, skin transplantation, nutritional support, and other conventional treatments were applied to all patients. Patients were sedated when they had obvious agitation or a tendency to extubate, which might lead to aggravation of the disease. REE measurement was performed on patients using indirect calorimetry on post-injury day 3, 5, 7, 9, 11, 14 and every 7 days thereafter until the patient died or being successfully weaned from ventilator. Totally 99 times of measurements were carried out, of which 58 times were measured in the sedated state of patients, and 41 times were measured in the non-sedated state of patients. The age, weight, body surface area, residual wound area, post-injury days of patients were recorded on the day when REE was measured (hereinafter briefly referred to as the measurement day). The REE on the measurement day was calculated with intensive care unit conventional REE estimation formula Thumb formula and special REE estimation formulas for burns including the Third Military Medical University formula, the Peng Xi team's linear formula, Hangang formula. The differences between the sedated state and the non-sedated state in the clinical materials, measured and formula calculated values of REE of patients on the measurement day were compared by Mann-Whitney U test and independent sample t test. The differences between the REE formula calculated values and the REE measured value (reflecting the overall consistency) in the sedated state were compared by Wilcoxon signed rank-sum test. The Bland-Altman method was used to assess the individual consistency between the REE formula calculated value and the REE measured value in the sedated state, and to calculate the proportion of the REE formula calculated value within the range of ±10% of the REE measured value (hereinafter referred to as the accuracy rate). Root mean square error (RMSE) was used to evaluate the accuracy of the REE formula calculated value relative to the REE measured value. Results: Compared with those in the non-sedated state, there was no statistically significant change in patient's age or post-injury days on the measurement day in the sedated state (P>0.05), but the weight was heavier (Z=-3.58, P<0.01), and both the body surface area and the residual wound area were larger (with Z values of -2.99 and -4.52, respectively, P<0.01). Between the sedated state and the non-sedated state, the REE measured values of patients were similar (P>0.05). Compared with those in the non-sedated state, the REE values of patients calculated by Thumb formula, the Third Military Medical University formula, the Peng Xi team's linear formula, and Hangang formula on the measurement day in the sedated state were significantly increased (with Z values of -3.58 and -5.70, t values of -3.58 and -2.74, respectively, P<0.01). In the sedated state, compared with the REE measured value, there were statistically significant changes in REE values of patients calculated by Thumb formula, the Third Military Medical University formula, and Hangang formula on the measurement day (with Z values of -2.13, -5.67, and -3.09, respectively, P<0.05 or P<0.01), while the REE value of patients calculated by the Peng Xi team's linear formula on the measurement day did not change significantly(P>0.05). The analysis of the Bland-Altman method showed that in the sedated state, compared with the REE measured value, the individual consistency of the calculated value of each formula was good; Thumb formula and Hangang formula significantly underestimated the patients' REE value (with the average value of the difference between the formula calculated value and the measured value of -1 463 and -1 717 kJ/d, the 95% confidence interval of -2 491 to -434 and -2 744 to -687 kJ/d, respectively), but the individual differences were small; the Third Military Medical University formula significantly overestimated the patients' REE value (with the average value of the difference between the formula calculated value and the measured value of 3 530 kJ/d, the 95% confidence interval of 2 521 to 4 539 kJ/d), but the individual difference was small; the Peng Xi team's linear formula did not significantly overestimate the patients' REE value (with the average value of the difference between the formula calculated value and the measured value of 294 kJ/d, the 95% confidence interval of -907 to 1 496 kJ/d), while the difference standard deviation was 4 568 kJ/d, which showed a large individual difference. In the sedated state, relative to the REE measured value, the accuracy rates of REE values calculated by Thumb formula, the Third Military Medical University formula, the Peng Xi team's linear formula, and Hangang formula were 25.9% (15/58), 15.5% (9/58), 10.3% (6/58), and 15.5% (9/58), respectively, and RMSE values were 4 143.6, 5 189.1, 4 538.6, and 4 239.8 kJ/d, respectively. Conclusions: Sedative therapy leads to a significant decrease in REE in patients with extremely severe burns undergoing mechanical ventilation treatment. When REE cannot be regularly monitored by indirect calorimetry to determine nutritional support regimens, patients with extremely severe burns undergoing sedation may be prioritized to estimate REE using Thumb formula.
Burns/therapy*
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Calorimetry, Indirect
;
Energy Metabolism
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Female
;
Humans
;
Male
;
Nutritional Support
;
Retrospective Studies
3.Co-amorphous technology to improve dissolution and physical stability of silybin.
Huan LIU ; Guo-Wei ZHAO ; Qie-Ying JIANG ; Xin-Li LIANG ; Liao-Qi OUYANG ; Hai-Bo DING ; Xu-Long CHEN ; Zheng-Gen LIAO
China Journal of Chinese Materia Medica 2022;47(1):103-110
The present study explored the effect of co-amorphous technology in improving the dissolution rate and stability of silybin based on the puerarin-silybin co-amorphous system prepared by the spray-drying method. Solid-state characterization was carried out by powder X-ray diffraction(PXRD), polarizing microscopy(PLM), Fourier transform infrared spectroscopy(FT-IR), differential scanning calorimetry(DSC), etc. Saturated powder dissolution, intrinsic dissolution rate, moisture absorption, and stability were further investigated. The results showed that puerarin and silybin formed a co-amorphous system at a single glass transition temperature which was higher than that of any crude drug. The intrinsic dissolution rate and supersaturated powder dissolution of silybin in the co-amorphous system were higher than those of the crude drug and amorphous system. The co-amorphous system kept stable for as long as three months under the condition of 40 ℃, 75% relative humidity, which was longer than that of the single amorphous silybin. Therefore, the co-amorphous technology could significantly improve the dissolution and stability of silybin.
Calorimetry, Differential Scanning
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Desiccation
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Drug Compounding/methods*
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Drug Stability
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Silybin
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Solubility
;
Spectroscopy, Fourier Transform Infrared
;
Technology
;
X-Ray Diffraction
4.Design and Verification of Human Metabolic Measurement System Based on STM32.
Rui JIN ; Hai-Hong HUANG ; Yuan WANG ; Yan-Yan CHEN ; Qing-Qing CAO ; Rui-de LIU ; Zi-Jun HE ; Yi-Ning SUN ; Zu-Zhang MA
Chinese Journal of Medical Instrumentation 2022;46(3):273-277
A high-precision human metabolic measurement system is designed. The system uses STM32F103 as the main control chip to acquire oxygen, carbon dioxide and flow signals to calculate four quantitative indicators: oxygen consumption(VO2), carbon dioxide production(VCO2), respiratory entropy(RQ) and resting energy metabolism(REE), and finally uses an upper computer to display the calculation results.In this paper, the signal acquisition circuit design was carried out for the oxygen sensor, carbon dioxide sensor and flow sensor, and the validity of the device was verified with the American machine MGCDiagnositcs using Bland-Altman analysis method, and the results showed that the four parameters of VO2,VCO2, RQ and REE of both devices fell in the agreement interval of more than 95%. The device thus provides accurate metabolic measurements and offers an effective tool for the field of general health and clinical nutrition support in China.
Calorimetry, Indirect
;
Carbon Dioxide/metabolism*
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Energy Metabolism
;
Humans
;
Oxygen
;
Oxygen Consumption
5.Validation of the Novel Basal Metabolic Rate Prediction Equation Among Adult Overweight and Obese Filipino Patients
Maria Regina C. Santos ; Oliver Allan C. Dampil ; Donnabelle Faye Navarrete ; Karna Igasan ; Rina R. Reyes ; Sachi Yumul
Philippine Journal of Internal Medicine 2020;58(4):112-119
BACKGROUND: Various methods and equations are available to predict the basal metabolic rate (BMR). A published study comparing the Harris-Benedict Equation, Bioelectrical Impedance Analysis, and Indirect Calorimetry (IC), was done among Filipinos, and was able to obtain a novel formula for BMR. The purpose of this study is to validate this novel formula.
METHODS: This is a multi-center, cross-sectional, validation study of the novel BMR equation, done among adult overweight and obese Filipinos, who were seen at St. Luke’s Medical Center and Providence Hospital in Quezon City, Outpatient Clinics from August 2019 to March 2020. Purposive sampling was done, and upon giving consent, subjects had undergone interview, anthropometrics measurement, and IC.
RESULTS: 174 samples were enrolled. Mean age is 43 years old, majority are females. 27% have no co-morbidities; of those with co-morbidities, half have diabetes mellitus (DM). Mean weight is 74.30 kg; mean BMI is 29.78 kg/m2 . The mean computed BMR is 1174.70 kcal/day, which is 145.83 significantly lower than the BMR derived with calorimetry: 1320.53 kcal/day (P-value 0.000). However, the scatterplot reveals the linearity of positive direction for both values. 31% of the computed BMR fell within the +/-10% estimate of the actual BMR. Stratification of the results between those with DM and without, lowered the difference between the calculated and actual BMR to 46 kcal/day (from 145.83) among the DM subgroup, and increased the estimated accuracy to 38% falling within the +/- 10% estimate of the actual values.
CONCLUSION: The novel BMR formula is linearly reflective of the basal metabolism of adult overweight and obese Filipinos, but the numerical values are lower compared to actual calorimetry results, yielding more accuracy when applied among patients with diabetes.
Calorimetry, Indirect
;
Basal Metabolism
;
Obesity Management
6.The effects of repetitive firing processes on the optical, thermal, and phase formation changes of zirconia
Alper OZDOGAN ; Hatice OZDEMIR
The Journal of Advanced Prosthodontics 2020;12(1):9-14
PURPOSE: The aim of this study was to investigate the effect of different numbers of heat treatments applied to superstructure porcelain on optical, thermal, and phase formation properties of zirconia.MATERIALS AND METHODS: Forty zirconia specimens were prepared in the form of rectangular prism. Specimens were divided into four groups (n = 10) according to the number of firing at heating values of porcelain. Color differences and translucency parameter were measured, and X-ray diffraction (XRD) analysis and differential scanning calorimetry (DSC) were performed. Data were analyzed with analysis of variance (ANOVA).RESULTS: There were no statistically significant differences in ΔE, TP, L, a, and b value changes of the zirconia specimens as a result of repetitive firing processes (P>.05).CONCLUSION: Although additional firing processes up to 4 increase peak density in thermal analysis, additional firing processes up to 4 times can be applied safely as they do not result in a change in color and phase character of zircon frameworks.
Calorimetry, Differential Scanning
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Dental Porcelain
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Fires
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Heating
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Hot Temperature
;
X-Ray Diffraction
7.Basal Energy Expenditure of Chinese Healthy Adults: Comparison of Measured and Predicted Values.
De Qian MAO ; Jing Huan WU ; Cheng Yu HUANG ; Ke Ji LI ; Xiao Li LIU ; Shi Lian ZHANG ; Yan Ling WANG ; Wei CHEN ; Ming LI ; Xiao Guang YANG ; Jian Hua PIAO
Biomedical and Environmental Sciences 2020;33(8):566-572
Objective:
This study aimed to measure the basal energy expenditure (BEE) of Chinese healthy adults and establish an accurate predictive equation for this population.
Methods:
In total, 470 Chinese healthy adults had their BEE measured using the Cosmed K4b portable metabolic system. Multiple linear regression analysis was applied to develop new optimal equations for predicting BEE. The bias, accuracy rate, concordance correlation coefficient (CCC), and root mean square error (RMSE) were used to evaluate the accuracy of the predictive equations.
Results:
There was a significant difference in BEE between males and females, with 5,954 kJ/d and 5,089 kJ/d, respectively. People living in rural areas expended significantly higher BEE (5,885 kJ/d) than those in urban areas (5,279 kJ/d). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), and Liu overestimated the BEE of Chinese healthy adults. The new equations derived from the present study displayed the smallest average bias and RMSE from the measured basal energy expenditure (mBEE). The CCC of the new equations was higher than other predictive equations, but it was lower than 0.8. There was no significant difference in the accuracy rate among all predictive equations.
Conclusions
Sex and regional differences in BEE were observed in Chinese healthy adults. Neither the widely used previous predictive equations nor the one derived in the present study were accurate enough for estimating the BEE of Chinese healthy adults. Further study is required to develop more accurate equations for predicting the BEE of Chinese healthy adults aged between 20-45 years.
Adult
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Basal Metabolism
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Calorimetry
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methods
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China
;
Female
;
Humans
;
Male
;
Young Adult
8.Preparation, characterization, and in vivo evaluation of a polymorphic form of valnemulin hydrogen tartrate
Xinle ZHU ; Shixin XU ; Lianshou LU ; Shensen WANG ; Qi ZHAO ; Dan LI ; Jian LI ; Hui ZHAO ; Bingen XU
Journal of Veterinary Science 2019;20(2):e16-
We prepared a polymorphic form of valnemulin hydrogen tartrate (Form I) to overcome the instability and irritating odor of valnemulin hydrochloride that affect its use in the production and application of veterinary drugs. The physicochemical properties of Form I were characterized by scanning electron microscopy, X-ray powder diffraction, infrared spectroscopy, differential scanning calorimetry, and thermogravimetric analysis. The results showed the crystal structure and thermal properties of Form I were very different from those of a commercially available form of valnemulin hydrogen tartrate (Form II). Form I and Form II were more stable than valnemulin hydrochloride after storage under irradiation and high humidity conditions, respectively. The solubility of Form I was 2.6 times that of Form II, and Form I was selected for use in pharmaceutical kinetics experiments in vivo. Compared to valnemulin hydrochloride, after oral administration at a dose of 10 mg/kg in pigs, Form I had similar pharmaceutical kinetic behavior but a slightly higher area under the concentration–time curve from time zero to the last measurable concentration. Consequently, Form I should be suitable for the development of simple formulations and be effective in the clinical application of veterinary drugs.
Administration, Oral
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Calorimetry, Differential Scanning
;
Humidity
;
Hydrogen
;
Kinetics
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Microscopy, Electron, Scanning
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Odors
;
Pharmacokinetics
;
Powder Diffraction
;
Solubility
;
Spectrum Analysis
;
Swine
;
Veterinary Drugs
9.Analysis of protective mechanism of silk protein based cryoprotectants.
Xinli ZHOU ; Yukun DU ; Yun TENG ; Xiaomin ZHANG
Journal of Biomedical Engineering 2019;36(6):986-993
Dimethyl sulfoxide (Me SO) supplemented with fetal bovine serum (FBS) is a widely used cryoprotectant combination. However, high concentration of Me SO is toxic to cells, and FBS presents problems related to diseases such as bovine spongiform encephalopathy and viral infections. Silk protein is a kind of natural macromolecule fiber protein with good biocompatibility and hydrophilicity. The aim of this paper is to analyze the cryoprotective mechanism of silk protein as cryoprotectant. Firstly, differential scanning calorimetry (DSC) was used to measure the thermal hysteresis activity (THA) of silk protein. The THA of 10 mg/mL sericin protein was 0.96°C, and the THA of 10% (V/V) fibroin protein was 1.15°C. Then the ice recrystallization inhibition (IRI) of silk protein-PBS solution was observed with cryomicroscope. The cold stage was set at - 7°C, after 40 minutes' incubation, the mean grain size rate (MGSR) of sericin protein and fibroin protein were 28.99% and 3.18%, respectively, which were calculated relative to phosphate buffer saline (PBS) control. It is indicated that sericin and silk fibroin have certain effects of inhibiting recrystallization of ice crystals. Finally, the structure and physicochemical properties of silk protein were analyzed by Fourier transform infrared spectroscopy (FTIR). The results showed that the content of the random coil was 75.62% and the β-sheet structure was 24.38% in the secondary of sericin protein. The content of the β-sheet structure was 56.68%, followed by random coil structure 22.38%, and α-helix 16.84% in the secondary of fibroin protein. The above analysis demonstrates the feasibility of silk fibroin as a cryoprotectant, and provides a new idea for the selection of cryoprotectants in the future.
Animals
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Bombyx
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Calorimetry, Differential Scanning
;
Fibroins
;
Sericins
;
Silk
;
Spectroscopy, Fourier Transform Infrared
10.Preparation, characterization and dissolution characteristics of dragon's blood extract nanosuspensions.
Li-Fang WANG ; Xiao-Nan CHEN ; Jun LI ; Peng-Fei TU ; Jin-Ling WANG
China Journal of Chinese Materia Medica 2019;44(11):2236-2243
The single-factor test was used to optimize the high-pressure homogenization method to prepare the phenolic extract nanosuspensions(DBNs). The physicochemical properties of the obtained nanosuspensions were characterized and the cumulative release in vitro was evaluated. The results showed that the drug concentration was 0.5 g·L~(-1), the mass concentrations of PVPK30 and SDS were 0.5 and 0.25 g·L~(-1), respectively, the probe ultrasonic time was 5 min, the homogenization pressure was 900 bar, and the number of homogenization was 2 times. The prepared DBNs had an average particle size of(168.80±0.36) nm, polydispersity index(PDI) of 0.09±0.04, stability index(SI) of 0.85, and DBNs were stable for storage within 30 days. Scanning electron microscopy showed that the particle size of the dragon's blood extract was reduced and the uniformity was improved in the obtained nanosuspensions. X-ray diffraction pattern and differential scanning calorimetry showed that the phenolic extract of dragon's blood was still in an amorphous state after being prepared into nanosuspensions. The results of saturated solubility measurement showed that the solubility of DBNs lyophilized powder reached 6.25 g·L~(-1), while the solubility of DB raw powder was only 28.67 mg·L~(-1). The in vitro dissolution experiments showed that DBNs lyophilized powder accumulated in gastrointestinal fluid for 8 h. The release amount was 90%,the cumulative release of the raw powder in the gastrointestinal fluid for 24 h was less than 1%, and the solubility and dissolution rate of the DBNs lyophilized powder were significantly higher than the DB raw powder. The method is simple in process and convenient in operation, and can successfully prepare uniform and stable nanosuspensions to improve its solubility, and provides a research basis for solving the application limitation of dragon's blood extract.
Calorimetry, Differential Scanning
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Nanoparticles
;
Particle Size
;
Plant Extracts
;
chemistry
;
Solubility
;
Suspensions
;
X-Ray Diffraction


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