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The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
To evaluate the short-term and long-term clinical effectiveness and safety of subthalamic nucleus deep brain stimulation (STN-DBS) for medically intractable pediatric isolated dystonia.
Using a longitudinal retrospective design, we assessed the clinical outcomes of nine patients who underwent STN-DBS for treatment-refractory pediatric isolated dystonia one decade ago (mean age at surgery: 15.9 ± 4.5 years). The primary clinical outcome used was assessed by retrospective video analyses of patients’ dystonia symptoms using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS). Clinical assessments were performed at baseline, 1-year follow-up (1-yr FU), and 10-year follow-up (10-yr FU). Adverse side effects, including surgery-related, device-related, and stimulation-related effects, were also documented.
After STN-DBS surgery, the mean improvement in the BFMDRS motor score was 77.1 ± 26.6% at 1-yr FU and 90.4 ± 10.4% at 10-yr FU. Similarly, the mean BFMDRS disability score was improved by 69.5 ± 13.6% at 1-yr FU and by 86.5 ± 13.9% at 10-yr FU. The clinical improvements gained at 10-yr FU were significantly larger than those observed at 1-yr FU. Negative correlations were found between the duration of disease to age at surgery ratio (DD/AS) and the improvements in the BFMDRS motor score and total score at 1-yr FU and 10-yr FU.
To our knowledge, this study provides the first clinical evidence for the short- and long-term effectiveness and safety of STN-DBS for pediatric isolated dystonia. Additionally, putative evidence is provided that earlier STN-DBS intervention in patients with refractory pediatric isolated dystonia may improve short- and long-term clinical outcomes.
Objective: The incidence, types, and influencing factors of injuries due to snow-ice disasters are essential for public health preparedness. This study was designed to assess such factors of injuries during the 22-day snowstorm in Ningbo, Zhejiang Province, China, in 2008.
Methods: A multistage cluster probability sampling method was applied to select the study population in urban, rural, and mountainous areas. Data including sociodemographic characteristics, frequency, and types of injuries during the snowstorm between January 20 and February 10, 2008, were obtained by face-to-face interviews using a structured questionnaire and by checking the participants' medical records. Univariate and multivariate regression analyses were used to determine the factors significantly associated with the risk of injuries.
Results: A total of 3169 residents of 1416 families took part in this survey. In 581 residents, 602 injuries were identified. Incidences of frostbite, falling injury, and traffic accident–related injury were 12.78%, 5.30%, and 0.50%, respectively. Injury occurred more frequently in women than in men (odds ratio [OR], 1.42; 95% CI, 1.19-1.70). Frostbite occurred more frequently in women than in men (adjusted OR, 1.86; 95% CI, 1.43-2.41) and more frequently in urban areas than in other areas (adjusted OR, 1.65; 95% CI, 1.24-2.20). Travel by bus or car, wearing a scarf, wearing gloves, wearing a raincoat, reducing outdoor activity, and performing regular physical exercise were independent protective factors of frostbite, with an adjusted OR (95% CI) of 0.35 (0.20-0.61), 0.45 (0.33-0.62), 0.35 (0.26-0.48), 0.45 (0.33-0.61), 0.36 (0.27-0.48), and 0.18 (0.13-0.24), respectively. Falling injury occurred more often in mountainous areas than in other areas (adjusted OR, 1.74; 95% CI, 1.27-2.42). Age 45 years or older, working outside more than 15 days, and wearing a raincoat were independent risk factors of falling injury, with an adjusted OR (95% CI) of 2.30 (1.60-3.32), 1.92 (1.36-2.72), and 2.21 (1.56-3.11), respectively. Falling and traffic accident–related injuries were mainly due to slippery roads.
Conclusions: Frostbite and falling injury were the major injuries caused by an unprecedented snow-ice disaster. Keeping warm and maintaining regular physical exercise appeared to reduce frostbite risk. Public health intervention also reduced the risk of falling and traffic accident–related injuries.
(Disaster Med Public Health Preparedness. 2012;6:363-369)
Recombinant bovine lactoferrin N-terminal polypeptide (rbLF-N) Escherichia coli expression system was constructed and the rbLF-N antimicrobial activity was displayed by enzymatic proteolysis in this study. A 162 bp 5′-terminal fragment of bovine lactoferrin (bLF) gene from bovine liver gDNA was amplified by PCR. The DNA fragment containing exon-2 of the bLF gene was cloned into the expression vector pGEX-4T1 and the glutathione-S-transferase–rbLF-N (GST-rbLF-N) fusion protein was obtained by over-expression in Esch. coli BL21(DE3). After thrombin/pepsin digestion, the rbLF-N was released from the fusion protein. The recombinant peptide was separated and identified by SDS-PAGE, HPLC and LC-MS/MS analysis. A very strong anti-food-born microbial pathogen activity of the rbLF-N peptides was displayed through bio- and kinetic-assays in vitro. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the rbLF-N peptide for bacterial pathogens Staphylococcus aureus, Streptococcus mutans, Esch. coli and Klebsiella pneumoniae were 11·7, 11·7, 11·7, 23·4 μg and 23·4, 11·7, 11·7, 46·4 μg, respectively. This study created a new route for exploring lactoferrin peptide application in food science.
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