Association between depression and malnutrition in pulmonary tuberculosis patients:A cross-sectional study

BACKGROUND Depression has been reported to be prevalent in patients with pulmonary tuberculosis(PTB).Moreover,several clinical symptoms of PTB and depression overlap,such as loss of appetite and malnutrition.However,the association between depression and malnutrition in TB patients has not been fully elucidated.AIM To explore the association between depression and malnutrition in patients with PTB.METHODS This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019.The Patient Health Questionnaire-9(PHQ-9)scale was used to evaluate depression.The cut-off value was set at 10,and the nutritional state was determined by the body mass index(BMI).In addition,the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life(QOL).Univariable analysis and multivariable analysis(forward mode)were implemented to identify the independent factors associated with depression.RESULTS A total of 328 PTB patients were screened for analysis.Eight were excluded for missing demographic data,four excluded for missing nutrition status,and sixteen for missing QOL data.Finally,300 PTB patients were subjected to analysis.We found that depressive state was present in 225 PTB patients(75%).The ratio of malnutrition in the depressive PTB patients was 45.33%.Our results revealed significantly lower BMI,hemoglobin,and prealbumin in the depression group than in the control group(P<0.05).Moreover,the social status differed significantly(P<0.05)between the groups.In addition,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group(P<0.05).Multivariable logistic regression analysis showed that BMI[odds ratio(OR)=1.21,95%confidence interval(CI):1.163-1.257,P<0.001]and poor social function(OR=0.95,95%CI:0.926-0.974,P=0.038)were independently associated with depression.CONCLUSION Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients.A prospective large-scale study is needed to confirm these findings.

Summary of the Best Evidence for Preoperative Pre-Rehabilitation in Patients with Lung Cancer Complicated with COPD

Objective: To search, evaluate and integrate the best domestic and foreign evidence on the preoperative pre-rehabilitation of lung cancer patients with COPD, and summarize the best evidence. Methods: Cochrane Library, BMJ Best Practice, JBI Center for International Cooperation in Evidence-Based Health Care Library, and Up to were searched by computer system Date, Embase, CINAHL, PubMed, Evidence-Based Health Care Center Database (JBI), American Guidenet, Global Guidenet, CNKI, CMBM, Wanfang, and VIP databases on preoperative pre-rehabilitation of patients with lung cancer and COPD. Literature screening and quality evaluation were conducted independently by two researchers, and evidence was extracted, summarized and summarized according to the theme. Results: A total of 13 kinds of literature were included, including 4 guidelines, 4 systematic reviews, 3 evidence summaries, and 2 expert consensus articles. This paper summarizes 44 best evidence on pre-rehabilitation of lung cancer patients with COPD, including 8 aspects: pre-rehabilitation content and principle, pre-rehabilitation assessment, exercise rehabilitation, nutrition management, psychological guidance, health education, multidisciplinary cooperation, quality control and follow-up. Conclusion: The best evidence of preoperative pre-rehabilitation for patients with lung cancer complicated with COPD is rich in content, and needs to be selected according to the characteristics of the hospital and the clinical environment. Some of the evidence still needs to be confirmed by higher-quality studies. .

Summary of the Best Evidence for the Evaluation and Management of Chemotherapy-Related Nausea and Vomiting in Cancer Patients

Objective: To summarize the best evidence for the evaluation and management of chemotherapy-related nausea and vomiting in cancer patients, so as to promote the standardized management of chemotherapy-related nausea and vomiting in cancer patients. Methods: A computer search was conducted for all evidence on chemotherapy-associated nausea and vomiting interventions, including guidelines, expert consensus, best clinical practice information booklet, recommended practice, evidence summary, and systematic review. The search period is from April 30, 2022. After the literature quality evaluation, the evidence extraction and summary of the literature meeting the quality standards. Results: A total of 16 literatures were included, including 9 guidelines, 5 systematic reviews and 2 expert consensus papers. 46 pieces of best evidence on the assessment and management of chemotherapy related nausea and vomiting in cancer patients were summarized, including 6 aspects including risk assessment and management, non-drug management, drug management, multidisciplinary cooperation, education and training, and health education. Conclusion: This study summarized the current best evidence on the assessment and management of chemotherapy-related nausea and vomiting in cancer patients. Clinical staff should apply evidence according to specific clinical scenarios, professional skills and patients’ wishes in order to reduce the degree and incidence of chemotherapy-related nausea and vomiting in cancer patients and improve the quality of care.

Nontuberculous mycobacteria： susceptibility pattern and prevalence rate in Shanghai from 2005 to 2008

Background An increasing incidence of disease caused by nontuberculous mycobacteria （NTM） is being reported. The purpose of this study was to determine the isolation rates of NTM from various clinical specimens, and their antimicrobial susceptibility patterns, over a 4-year period in Shanghai. Methods All NTM isolated between 2005 and 2008 at Shanghai Pulmonary Hospital, a key laboratory of mycobacteria tuberculosis in Shanghai, China, were identified with conventional biochemical tests and 16S rRNA gene sequencing. Antimicrobial susceptibility for all NTM was determined using the BACTEC MGIT 960 system. Results A total of 21 221 specimens were cultured, of which 4868 （22.94%） grew acid fast bacilli （AFB）, and 248 （5.09%） of the AFB were NTM. The prevalence rate of NTM was determined as 4.26%, 4.70%, 4.96% and 6.38% among mycobacteria culture positive samples in years 2005, 2006, 2007 and 2008 respectively. These data indicated that the prevalence rate has continuously increased. Sixteen different species of NTM were identified, the most commonly encountered NTM in Shanghai were M. chelonae （26.7%）, followed by M. fortuitum （15.4%）, M. kansasii （14.2%）, M. avium-intracellulare complex （13.1%） and M. terrae （6.9%）. The rare species identified were M. marinum, M. gastri, M. triviale, M. ulcerans, M. smegmatis, M. phlci, M. 9ordonae, M. szulgai, M. simiae, M. scrofulaceum and M. xenopi. The five most commonly identified NTM species showed high drug resistance to general anti-tuberculosis drugs, particularly, M. chelonae and M. fortuitum appear to be multi-drug resistance. Conclusions The prevalence of NTM in Shanghai showed a tendency to increase over the course of the study. The five most commonly isolated NTM species showed high drug resistance to first line anti-tuberculosis drugs.

Analysis of the clinical characteristics between cavitating squamous cell lung carcinoma and non-cavitating squamous cell lung carcinoma

Objective: To identify the differences between cavitating squamous cell lung carcinoma (cSLC) and non-cavitating squamous cell lung carcinoma (ncSLC). Methods: Fifty-one patients with cSLC and 281 with ncSLC confirmed by surgery in our hospital between 1999 to 2000 were collected and their clinical, histological and survival features were retrospectively analyzed. Results: Patients with cSLC had more frequent manifestation of infection and weight loss. They usually experienced longer duration of pre-diagnosis and showed bigger tumor mass, larger primary tumor invasion with worse differentiated than ncSLC patients. There was no significant difference in age, sex, smoking history, family tumor history, personal tuberculosis history, disease location, TNM stage, lymph node invasion, and metastasis between the two groups. Median survival time was 29 months for cSLC and 35 months for ncSLC. One- and 3- year survival rates were 86.3% and 43.1% for cSLC vs. 91.1% and 47.0% for ncSLC respectively (P>0.05). Conclusion: Patients with cSLC presented with a bigger mass, a larger extent of primary tumor invasion, worse differentiated, more obstructed pneumonia that might result in longer duration of pre-diagnosis and more weight loss. As lack of differences in disease stages, lymph node invasion, metastasis and especially survival time with ncSLC, cSLC couldn’t be classified as a special type of squamous cell carcinoma by present evidences.

Meta-Analysis of Aspirin for Primary Prevention of Stroke

Objective: This paper aims to evaluate the safety and efficacy of aspirin in primary stroke prevention by meta-analysis. Methods: By searching PubMed, Cochrane Library, Embase, MEDLINE, Web of Science, CNKI, China Biomedical Literature Database, VIP Database and Wanfang Database, we collected randomized controlled trials on aspirin for primary prevention of stroke. The retrieval time limit is from the establishment of the database to December 2021. Two researchers independently conducted literature search, screening, data extraction and quality evaluation, and Meta-analysis was performed using RevMan 5.3. Results: A total of 19 articles were included, including 220,636 subjects. Meta-analysis results show that long-term preventive use of aspirin can reduce the incidence of stroke [RR = 0.91, 95% CI (0.85, 0.98), P = 0.009], and reduce the incidence of ischemic stroke [RR = 0.84, 95% CI] (0.77, 0.91), P RR = 0.80, 95% CI (0.72, 0.88), P RR = 0.85, 95% CI (0.75, 0.97), P RR = 1.23, 95% CI (1.04, 1.46), P = 0.01] and gastrointestinal bleeding [RR = 1.62, 95% CI (1.35, 1.93), P RR = 0.97, 95% CI (0.93, 1.02), P = 0.20]. Conclusion: Long-term prophylactic use of aspirin can reduce the overall incidence of stroke, but there is also a risk of bleeding. The advantages and disadvantages of aspirin should be fully evaluated and strict screening should be carried out before medication, which can minimize adverse reactions and improve the safety and effectiveness of aspirin in the primary prevention of stroke.