Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis

AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.

Bioelectrical impedance vector analysis evaluates cellularity and hydration in cirrhotic patients

BACKGROUND Malnutrition in cirrhotic patients is correlated with mortality and a better response to liver transplantation.However,recovery of the nutritional status in these patients is a challenge due to the difficulty in establishing a reliable nutritional diagnosis.The bioelectrical impedance vector analysis(BIVA)method appears as a feasible tool in clinical practice to define the physiological state of cirrhotic patients by assessing hydration and body cellularity.AIM To evaluate body composition in cirrhotic patients using BIVA.METHODS This retrospective cross-sectional study was carried out by following cirrhotic outpatients at a hospital in Porto Alegre,Brazil.A tetrapolar bioelectrical impedance analysis device was used to evaluate cellularity and hydration and to perform the BIVA.The BIVA graphic was elaborated by software and for statistical analysis a significance level of 5%(P≤0.05)was considered.RESULTS One hundred and ninety patients,61.1%males,with a mean age of 56.6±11.0 years,were evaluated.Of these,56.3%had Child-Turcotte-Pugh(CTP)A score,and the prevalent etiology was hepatitis C virus(47.4%).The patients were classified according to cellularity and hydration by the quadrants and ellipses of the BIVA method,quadrant 1(47.9%);quadrant 2(18.9%);quadrant 3(14.2%);and quadrant 4(18.9%).Those classified in quadrant 1 and 2 had a higher phase angle compared to those in quadrants 3 and 4(P<0.001).Quadrant 2 patients had a lower average age than the other groups.The association with CTP score showed that patients in quadrant 2 had a higher proportion of CTP A,and those in quadrant 4 had a higher proportion of CTP C(P<0.052).CONCLUSION The BIVA method allows identification of the cellularity and hydration status of cirrhotic patients,and its association with clinical factors determines the disease severity,age and prognostic index.

Bioelectrical impedance analysis-guided fluid management promotes primary fascial closure after open abdomen:a randomized controlled trial

Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)patients.Bioelectrical impedance analysis(BIA)is a promising tool for monitoring fluid status and FO.Therefore,we sought to investigate the efficacy of BIA-directed fluid resuscitation among OA patients.Methods:A pragmatic,prospective,randomized,observer-blind,single-center trial was performed for all trauma patients requiring OA between January 2013 and December 2017 to a national referral center.A total of 140 postinjury OA patients were randomly assigned in a 1:1 ratio to receive either a BIA-directed fluid resuscitation(defined as BIA)protocol that included fluid administration with monitoring of hemodynamic parameters and different degrees of interventions to achieve a negative fluid balance targeting the hydration level(HL)measured by BIA or a traditional fluid resuscitation(TRD)in which clinicians determined the fluid resuscitation regimen according to traditional parameters during 30 d of intensive care unit(ICU)management.The primary outcome was the 30-day primary fascial closure(PFC)rate.The secondary outcomes included the time to PFC,postoperative 7-day cumulative fluid balance(CFB)and adverse events within 30 d after OA.The Kaplan–Meier method and the log-rank test were utilized for PFC after OA.A generalized linear regression model for the time to PFC and CFB was built.Results:A total of 134 patients completed the trial(BIA,n=66;TRD,n=68).The BIA patients were significantly more likely to achieve PFC than the TRD patients(83.33%vs.55.88%,P<0.001).In the BIA group,the time to PFC occurred earlier than that of the TRD group by an average of 3.66 d(P<0.001).Additionally,the BIA group showed a lower postoperative 7-day CFB by an average of 6632.80 ml(P<0.001)and fewer complications.Conclusions:Among postinjury OA patients in the ICU,the use of BIA-guided fluid resuscitation resulted in a higher PFC rate and fewer severe complications than the traditional fluid resuscitation strategy.

Body Composition Estimatives by Anthropometry, Bioelectrical Impedance and Deuterium Oxide Dilution in Obese Adolescents

To evaluate the relationship between measures of body composition in obese adolescents by the methods of bioelectrical impedance analysis, deuterium oxide dilution and anthropometric measures, proposing an equation. The variables were weight, height, BMI, triceps and subscapular skinfold thickness, waist and arm muscle circumference, lean body mass, fat mass and total body water by bioelectrical impedance and deuterium oxide dilution methods. The study included 40 obese adolescents, 45% male, age distribution was 2.42 ± 1.19 years and females 55%, and the predominant age was 12.61 ± 1.78. Linear regression equations were developed, capable of predicting body composition from information supplied by the method of deuterium oxide dilution (gold standard), bioelectrical impedance and anthropometry. The variables gender, age, height, arm circumference, triceps and suprailiac skin fold thickness, resistance and reactance were used to estimate lean body mass, fat mass and total body water by the method of deuterium and significantly correlated with variables, resistance, reactance, sex and total body water (TBW) by bioimpedance method. Among the equations developed, five were suitable for this sample, therefore, it is suggested that more studies should be done to test the applicability of the equations in other samples so that we can validate the equations encountered in obese adolescents.

Bioelectrical Impedance Phase Angle as a Predictors of Mortality in Patients with Lung Cancer:a Prospective Study

Objective Bioelectrical impedance analysis(BIA)is used to measure a patient's body composition.The phase angle(PA),the major parameter in BIA,is one of the most sensitive indicators of malnutrition.The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients.Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital.Anthropometric measurements,hematological values,the nutritional risk screening(NRS 2002)score,patient generated-subjective global assessment(PG-SGA)score,Karnofsky performance status(KPS)scale,European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ C-30)score,and BIA were investigated within 48 hours after admission to the hospital.A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA.A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival(OS)and PA.Results The mean age for all patients was 63 years old(42 females and 124 males).The median PA was 5.5°(4.70°,6.23°).The PA was positively associated with the body mass index,hand grip strength,mid-arm circumference,mid-arm muscle circumference,albumin,prealbumin,C-reactive protein,red blood cells,hemoglobin and KPS score.The PG-SGA scores,QLQ-C30 score,and NRS2002 score showed a significant negative association with the PA.According to a multivariate analysis,the PA(HR=0.47;95%CI:0.27-0.81)was independent predictor of the lung cancer patients'long-term OS.Patients with a higher PA(≥5°)had better overall survival(median=426 days)compared to those with a lower PA(<5°)(median=96 days)based on the one-year follow-up data(P<0.0001).Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.

Non-electric bioelectrical analog strategy by a biophysical-driven nano-micro spatial anisotropic scaffold for regulating stem cell niche and tissue regeneration in a neuronal therapy

The slow regenerating rate and misdirected axonal growth are primary concerns that disturb the curative outcome of peripheral nerve repair.Biophysical intervention through nerve scaffolds can provide efficient,tunable and sustainable guidance for nerve regrowth.Herein,we fabricate the reduced graphene oxide(rGO)/polycaprolactone(PCL)scaffold characterized with anisotropic microfibers and oriented nanogrooves by electrospinning technique.Adipose-derived stem cells(ADSCs)are seeded on the scaffolds in vitro and the viability,neural differentiation efficiency and neurotrophic potential are investigated.RGO/PCL conduits reprogram the phenotype of seeded cells and efficiently repair 15 mm sciatic nerve defect in rats.In summary,biophysical cues on nerve scaffolds are key determinants to stem cell phenotype,and ADSC-seeded rGO/PCL oriented scaffolds are promising,controllable and sustainable approaches to enable peripheral nerve regeneration.

Rapid on-line non-destructive detection of the moisture content of corn ear by bioelectrical impedance spectroscopy

Moisture content of corn directly affects its quality and storage time,and the rapid on-line detection of the moisture content of corn ears not threshed or in vivo in the fields is required.Because of the special shape of corn ear,the rapid,low cost and non-destructive bioelectrical impedance measurement is more suitable for its moisture content detection.Using the four-electrode method with the Agilent E4980A precision LCR meter,the electrical impedance spectroscopies of the sweet corn ears and waxy corn ears at different moisture contents were acquired.The frequency range of the detection was from 20 Hz to 2 MHz and to enhance the contact,the attached-type electrodes were wrapped in cotton soaked with 0.1%NaCl solution.The impedance data over the frequency range from 300 Hz to 5 kHz were used to obtain the parameters of the bio-impedance Cole-Cole model.The results showed a good linear correlation(coefficient of determination R2=0.960)between the equivalent parallel resistance R∞of sweet corn ear and the moisture content value determined by standard chemical method.The research proved that the bioelectrical impedance spectroscopy can be used for detecting the moisture content of corn ear.

Chemico-biological conversion of carbon dioxide

The unabated carbon dioxide(CO_(2))emission into the atmosphere has exacerbated global climate change,resulting in extreme weather events,biodiversity loss,and an intensified greenhouse effect.To address these challenges and work toward carbon(C)neutrality and reduced CO_(2)emissions,the capture and utilization of CO_(2)have become imperative in both scientific research and industry.One cutting-edge approach to achieving efficient catalytic performance involves integrating green bioconversion and chemical conversion.This innovative strategy offers several advantages,including environmental friendliness,high efficiency,and multi-selectivity.This study provides a comprehensive review of existing technical routes for carbon sequestration(CS)and introduces two novel CS pathways:the electrochemicalbiological hybrid and artificial photosynthesis systems.It also thoroughly examines the synthesis of valuable Cnproducts from the two CS systems employing different catalysts and biocatalysts.As both systems heavily rely on electron transfer,direct and mediated electron transfer has been discussed and summarized in detail.Additionally,this study explores the conditions suitable for different catalysts and assesses the strengths and weaknesses of biocatalysts.We also explored the biocompatibility of the electrode materials and developed novel materials.These materials were specifically engineered to combine with enzymes or microbial cells to solve the biocompatibility problem,while improving the electron transfer efficiency of both.Furthermore,this review summarizes the relevant systems developed in recent years for manufacturing different products,along with their respective production efficiencies,providing a solid database for development in this direction.The novel chemical-biological combination proposed herein holds great promise for the future conversion of CO_(2)into advanced organic compounds.Additionally,it offers exciting prospects for utilizing CO_(2)in synthesizing a wide range of industrial products.Ultimately,the present study provides a unique perspective for achieving the vital goals of“peak shaving”and C-neutrality,contributing significantly to our collective efforts to combat climate change and its associated challenges.

Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.

Association of Breastfeeding Duration with Body Composition in Children Aged 3–5 Years

Objective This study aimed to assess the relationship between the body composition of children aged 3–5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0–17 years of age in China(CNHSC),a nationwide cross-sectional study.Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews.The body composition of preschool children was measured using bioelectrical impedance analysis.A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total,2,008 participants were included in the study.Of these,89.2%were ever breastfed and the median duration of breastfeeding was 12 months(IQR 7–15 months).Among children aged 3 years,the height-for-age Z-score(HAZ)for the ever breastfed group was lower than that for never breastfed group(0.12 vs.0.42,P=0.043).In addition,the weight-for-age Z-score(WAZ)of the ever breastfed group was lower than that of the never breastfed group(0.31 vs.0.65,P=0.026),and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed.Compared to the formula-fed children,the fat-free mass of breastfed infants was higher for children aged 3 years(12.84 kg vs.12.52 kg,P=0.015)and lower for those aged 4 years(14.31 kg vs.14.64 kg,P=0.048),but no difference was detected for children aged 5 years(16.40 kg vs.16.42 kg,P=0.910)after adjusting for potential confounders.No significant difference was detected in the weight-for-height Z-score(WHZ),body mass index(BMI)-for-age Z-score(BAZ),fat-free mass index,and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3–5 years.Conclusion No obvious associations were detected between breastfeeding duration,BMI,and fat mass indicators.Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

Suppression of transmembrane sodium currents on the freshly isolated hippocampal neuron cell with continuous infrared light

Physiotherapeutic effects of infrared lasers have been proved in clinic.These infrared-based regulations of the bioelectrical activities can roughly be classied into enhancement and suppression of action potential(AP),which are described by sodium(Na)and potassium(K)transmembrane current equations,named as Hodgkin and Huxley(HH)-model.The enhancement effect is able to evoke or strengthen the AP when infrared light is applied.Its corresponding mechanism is commonly ascribed to the changes of the cell membrane capacitance,which is transiently increased in response to the infrared radiation.The distinctive feature of the suppression effect is to inhibit or reduce the AP by the designed protocols of infrared radiation.However,its mechanism presents more complexity than that in enhancement cases.HH-model describes how the Na current determines the initial phase of AP.So,the enhancement and suppression of AP can be also ascribed to the regulations of the corresponding Na currents.Here,a continuous infrared light at the wavelength of 980 nm(CIS-980)was employed to stimulate a freshly isolated hippocampal neuron in vitro and a suppression effect on the Na currents of the neuron cell was observed.Both Na and K currents,which are named as whole cell currents,were simultaneously recorded with the cell membrane capacitance current by using a patch clamp combined with infrared irradiation.The results demonstrated that the CIS-980 was able to reversibly increase the capacitance currents,completely suppressed Na currents,but little changed K currents,which forms the steady outward whole cell currents and plays a major role on the AP repolarization.A conrmation experiment was designed and carried out by synchronizing tens of milliseconds of infrared stimulation on the same kinds of hippocampal neuron cells.After the blocked K channel,a reduction of Na current amplitude was still recorded.This proved that infrared suppression of Na current was irrelevant to K channel.A membrane capacitance mediation process was preliminarily proposed to explain the Na channel suppression process.

A Time-Varying Parameter Estimation Method for Physiological Models Based on Physical Information Neural Networks

In the establishment of differential equations,the determination of time-varying parameters is a difficult problem,especially for equations related to life activities.Thus,we propose a new framework named BioE-PINN based on a physical information neural network that successfully obtains the time-varying parameters of differential equations.In the proposed framework,the learnable factors and scale parameters are used to implement adaptive activation functions,and hard constraints and loss function weights are skillfully added to the neural network output to speed up the training convergence and improve the accuracy of physical information neural networks.In this paper,taking the electrophysiological differential equation as an example,the characteristic parameters of ion channel and pump kinetics are determined using BioE-PINN.The results demonstrate that the numerical solution of the differential equation is calculated by the parameters predicted by BioE-PINN,the RootMean Square Error(RMSE)is between 0.01 and 0.3,and the Pearson coefficient is above 0.87,which verifies the effectiveness and accuracy of BioE-PINN.Moreover,realmeasuredmembrane potential data in animals and plants are employed to determine the parameters of the electrophysiological equations,with RMSE 0.02-0.2 and Pearson coefficient above 0.85.In conclusion,this framework can be applied not only for differential equation parameter determination of physiological processes but also the prediction of time-varying parameters of equations in other fields.

生物电阻抗法在慢性肾脏病儿童营养评估中的应用

目的：探讨生物电阻抗原理（bioelectrical impedance analysis, BIA）在评价慢性肾脏病儿童营养方面的临床应用价值。方法选取2009年至2011年期间就诊于北京儿童医院肾脏内科的单中心慢性肾脏病（chronic kid-ney disease, CKD）患儿57例（CKD组），同时选择健康儿童54例作为正常对照组。利用生物电阻抗原理对儿童进行人体成分（主要包括蛋白质、脂肪含量的测定）的评估及比较。结果 CKD组蛋白质相对含量为（14.72±2.44）%，正常对照组为（18.10±3.91）%，两组间差异有统计学意义（t=2.61，P=0.000）；CKD组脂肪相对含量为（24.31±12.52）%，显著高于正常对照组的（16.1±17.34）%，差异有统计学意义（t=3.89，P=0.000）；CKD1~2期患儿蛋白质相对含量为（34.57±7.39）%，CKD3~5期患儿含量为（41.08±5.53）%，两者比较差异有统计学意义（t=3.749，P=0.000）；CKD1~2期患儿相对脂肪含量为（28.73±12.50）%，CKD3~5期患儿含量为（16.13±7.52）%，其差异有统计学意义（t=-4.745，P=0.000）。 CKD组中47例（82.45%）处于营养成分失衡状态；在身高别体重提示营养状况良好的32例CKD患儿中25例（78.12%）存在营养成分不均衡。结论 CKD患儿存在蛋白质、脂肪等人体成分不均衡状态，个体化、针对性的营养管理对CKD患儿的营养状况改善有一定帮助。生物电阻抗原理对于评价CKD患儿营养状况有一定的临床应用价值。

Nutritional evaluation in cirrhosis: Emphasis on the phase angle

Protein-calorie malnutrition(PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and nonanthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis(BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle(PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients' overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.

Measurement of body composition as a surrogate evaluation of energy balance in obese patients

In clinical practice obesity is primarily diagnosed through the body mass index. In order to characterize patients affected by obesity the use of traditional anthropometric measures appears misleading. Beyond the body mass index, there are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body componentsas free-fat mass, muscle mass, and fat mass. Among the numerous techniques actually available, bioelectrical impedance analysis seems to be the most suitable in a clinical setting because it is simple, inexpensive, noninvasive, and highly reproducible. To date, there is no consensus concerning the use of one preferred equation for the resting energy expenditure in overweight and/or obese population. Energy restriction alone is an effective strategy to achieve an early and significant weight loss, however it results in a reduction of both fat and lean mass therefore promoting or aggravating an unfavourable body composition(as sarcobesity) in terms of mortality and comorbidities. Therefore the implementation of daily levels of physical activity should be simultaneously promoted. The major role of muscle mass in the energy balance has been recently established by the rising prevalence of the combination of two condition as sarcopenia and obesity. Physical exercise stimulates energy expenditure, thereby directly improving energy balance, and also promotes adaptations such as fiber type, mitochondrial biogenesis, improvement of insulin resistance, and release of myokines, which may influence different tissues, including muscle.

Combining the Patient-Generated Subjective Global Assessment (PGSGA) and Objective Nutrition Assessment Parameters Better Predicts Malnutrition in Elderly Patients with Colorectal Cancer

Background Malnutrition is common in colorectal cancer(CRC)patients,especially in elderly patients.The Patient-Generated Subjective Global Assessment(PG-SGA)is a widely used tool developed to detect malnutrition.The aim of this study was to compare the value of the PG-SGA and objective nutrition assessment parameters,in order to identify a better predictive index for malnutrition in elderly patients with CRC.Methods A total of 131 elderly patients(age≥60 years)with CRC were included and were evaluated for their individual nutritional status using the PG-SGA.Anthropometric and serological indicators were also assayed within 48 h of admission to the hospital.Body composition analysis was implemented by bioelectrical impedance analysis(BIA)instrument.The Chi-squared test,univariate and multivariate logistic regression analysis,or Spearman’s rank correlation analysis were used to determine the differences among the above indices and parameters with regard to predicting malnutrition.Results According to the PG-SGA score,the incidence of total malnutrition in elderly patients with CRC was 80.92%(PG-SGA score≥2),which increased with age.It was found that 28%of the patients with PG-SGA classification A(PG-SGA score 0-1)had a low fat-free mass index(FFMI).Compared with those with PG-SGA A,patients with PG-SGA C PG-SGA score≥9)showed an increased neutrophil to lymphocyte ratio(NLR)and an increased platelet and lymphocyte ratio(PLR)(median=1.78 VS.2.35,P=0.015 and median=108.8 VS.141.6,P=0.001,respectively).In terms of objective nutrition assessment parameters,severely malnourished CRC patients had significantly lower values of serum albumin(ALB),and retinol conjugated protein(RBP)than those who were well-nourished[(38.35±4.84)g/L VS.(40.56±3.44)g/L,P=0.039 and(30.31±15.83)mg/L VS.(39.01±11.95)mg/L,P=0.033,respectively].The Spearman’s rank correlation analysis showed that the PG-SGA findings had positive correlations with the NLR and PLR;while it had negative correlations with the FFMI,body mass index(BMI),ALB,prealbumin,and RBP.Conclusions In clinical practice,a comprehensive nutritional diagnosis,including the PG-SGA score and these objective indicators,can avoid the underdiagnosis of malnutrition,and is more suitable to detect malnutrition(as well as its causes)in elderly patients with CRC.

Low Phase Angle Predicts Poor Survival in Patients with Hepatocellular Carcinoma:A Retrospective Study

Background The phase angle(PA)is an indicator of nutritional status derived from bioelectrical impedance analysis(BIA).Studies have shown that the PA is one of several factors related to the survival of cancer patients.However,the correlation between the PA and prognosis in patients with hepatocellular carcinoma(HCC)has not been reported.This study aimed to explore the relationship between the PA,nutrition-related indicators,and patient prognosis.Methods The data from 248 HCC patients who underwent BIA between January 2015 and December 2019 at the First Hospital of Jilin University were retrospectively analyzed.Patients were divided into two groups according to the median PA value,then the nutrition-related indicators and overall survival(OS)were compared between the two groups.The correlations between the PA and laboratory test nutrition-related indicators and the results of a body composition analysis were determined using Pearson correlation analysis.Independent predictors of the patient prognosis were identified using univariate and multivariate analyses.Results The median OS in the high and low PA groups were 70 and 54.6 months,respectively(P=0.004).The Pearson correlation analysis revealed that the PA was associated with both laboratory test nutrition-related indicators and the results of a body composition analysis.The multivariable Cox regression analysis identified the PA as an independent risk factor affecting the prognosis of patients with Barcelona Clinic Liver Cancer stage A or B.Conclusion The PA is a good biomarker for the nutritional status.We found that the PA was associated with the prognosis in patients with HCC,with a low PA indicating a poor nutritional status and worse prognosis.

Relationship between phase angle,steatosis,and liver fibrosis in patients coinfected with human immunodeficiency virus/hepatitis C virus

BACKGROUND Malnutrition,lipodystrophy,and dyslipidemia are prevalent characteristics in patients with human immunodeficiency virus(HIV)infection with or without previous treatment.Such a clinical condition can lead to the hypothesis of the presence of hepatic steatosis with possible progression to fibrosis and the risk of hepatocellular carcinoma.Notably,a low phase angle(PA),evaluated by bioelectrical impedance analysis(BIA),is an independent prognostic marker of clinical progression and survival in HIV-infected patients.AIM To evaluate the relationship between PA and body composition with steatosis and hepatic fibrosis in HIV/hepatitis C virus(HCV)-coinfected patients.METHODS A retrospective observational study by convenience sampling of coinfected HIV/HCV patients,in which all patients underwent transient elastography(Fibroscan)and BIA evaluation.Student’s t test was used for group comparisons,and Spearman’s or Pearson’s correlation test was used when appropriate.The significance level was set at 5%,and analyses were performed using SPSS version 21.0.RESULTS Forty-three patients who received antiretroviral therapy met the inclusion criteria,and 23(53.5%)were under treatment with protease inhibitors(PIs).There was no difference in PA between those who used PIs and those who did not(P=0.635).There was no correlation between fibrosis grade and PA(P=0.355)or lean mass(P=0.378).There was a significant inverse correlation between the controlled attenuation parameter(CAP)and lean mass(P=0.378),positive correlation between PA and lean mass(P=0.378),and negative correlation between PA and fatty mass(P=0.378),although the CAP and PA were not correlated.When evaluated by sex,no significant correlations were found.CONCLUSION PA determines the muscle function of HIV/HCV-coinfected patients,and the CAP values reinforce the association with lean mass,suggesting that patients require early nutritional interventions.

Melatoninergic Antidepressant in Post-Stroke Depression Therapy

This paper presents the results of the effects of Melitor (25 mg during two months) on the psychic-emotional state, cerebral hemodynamic and bioelectrical activity of the brain in 30 patients (average age 66.2 ± 3.2 years) with ischemic post-stroke depression. It has been found that this drug possesses a multimodal action which is characterized by the decrease of the level of depression, widening of the range of social-environmental activity, improvement of the cerebral blood circulation and harmonization of the brain electrogenesis. In the patients with right versus left hemisphere stroke, the effect of Melitor on the functional state of the brain was more pronounced. Based on the results obtained in our study, we can recommend Melitor to use it in complex scheme of rehabilitation care of patients of the given nosological category.

Measuring obesity: results are poles apart obtained by BMI and bio-electrical impedance analysis

Objective: To analyse the use of BMI and bioelectrical impedance analysis (BIA) in assessment of adiposity among young and elderly population. Materials and methods: Age, height, weight and percent body fat (PBF) of 101 young and 276 elder subjects were recorded. PBF was measured directly by BIA instrument (PBFb) and also calculated from BMI (PBFf). The classification of subjects into underweight, normal, overweight and obese was based on the age- and sex-specific BMI cutoff values and PBFb following standard guidelines. Results: The calculated mean BMI values of young and old age groups were statistically same. PBF was significantly high in elder subjects. There was no statistical difference in mean PBFb and PBFf in young subjects but the difference was significant in elder subjects. The PBFf values were highly correlated (r: 0.92 to 0.96) with PBFb values in young age groups unlike elder groups of both males and females. PBFb based categorization of subjects’ presented totally different scenario compared to results obtained by BMI analysis to assess adiposity. Conclusion: The cases such as increasing fatness with aging even when BMI remains constant, the causes of country or ethnic differences in BMI analysis, poor correlation in PBFb and PBFf values in elder age group emphasize on the limitations of BMI based analysis. PBFb within limitations seems to be an improved phenotypic characteristic over BMI.