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 prospec...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.展开更多
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 ...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.展开更多
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 difficul...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.展开更多
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. T...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.展开更多
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 ...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.展开更多
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 shap...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.展开更多
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 pat...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.展开更多
It is estimated in Western industrialized countries that inflammatory bowel disease(IBD)has a prevalence of 1 for every 200 inhabitants.In the past,the fat mass disproportionate increase in relation to the fat-free ma...It is estimated in Western industrialized countries that inflammatory bowel disease(IBD)has a prevalence of 1 for every 200 inhabitants.In the past,the fat mass disproportionate increase in relation to the fat-free mass was considered uncommon in patients with IBD,due to the observation of the disease being more common with weight loss and malnutrition.However,more in-depth investigations demonstrate that the fat/lean mass disproportion stands out both in prevalence in patients with new diagnoses of ulcerative colitis or Crohn's disease as well as a factor of poor prognosis to the natural evolution of the disease or to the therapeutic response.Another important aspect associated with obesity in IBD is the increased risk of drug clearance[including anti-tumor necrosis factor(TNF)and anti-integrin agents],resulting in short half-life and low trough drug concentrations,since the levels of TNF secreted by adipocytes sequester anti-TNF agents,which could result in suboptimal response to biologics.In view of these characteristic aspects of the inflammatory process of IBD,the identification of cellular functioning is necessary,which can be associated with the staging of the underlying disease,biochemical parameters,and body composition,helping as an indicator for a more accurate clinical and nutritional conduct.展开更多
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 Nutriti...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.展开更多
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 a...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.展开更多
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 patient...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.展开更多
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...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.展开更多
Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved...Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved hydration,improved upper airway health and increased heart rate variability.Two groups of Thoroughbred racehorses matched for physiological,training and racing attributes were studied for 4 weeks.One group(n=17)received 10 L(about 15%)of their daily water as SW(followed by ad libitum filtered deep well water)and the control group(n=15)only filtered deep well water.Blood samples and bioelectrical impedance analysis(BIA)measures were obtained at baseline,2 and 4 weeks.Hydration was assessed using BIA.The upper airway was assessed by nasopharyngeal endoscopy at baseline and weekly within 60 minutes of breezing.On weekly breeze days heart rate was recorded at rest,during exercise and recovery and data were analysed for heart rate variability.Compared to controls,horses drinking SW showed increased hydration improved upper airway health post-breezing and increased heart rate variability.It is concluded that drinking 10 L daily of SW increased hydration and may have conferred some wellness benefits.展开更多
Bioelectrical impedance analysis(BIA)is a noninvasive and reproducible technique for assessing changes in body composition and nutritional status.The phase angle(PA),a major parameter of BIA,is one of the most sensiti...Bioelectrical impedance analysis(BIA)is a noninvasive and reproducible technique for assessing changes in body composition and nutritional status.The phase angle(PA),a major parameter of BIA,is one of the most sensitive indicators used to detect malnutrition in patients,and is also a prognostic marker in various clinical diseases.The incidence of malnutrition in cancer patients is high,and malnutrition seriously affects the treatment process and prognosis of patients.Reasonable and effective nutritional interventions are therefore of great significance for cancer patients.Compared with traditional nutritional assessment tools,the PA has unique advantages in the nutritional assessment,efficacy monitoring and prognostic prediction of patients with malignant tumors,and it has broad application prospects in clinical practice.This article reviews the research progress on the application of the PA in patients with malignant tumors to provide clinicians with a tool to predict malnutrition,and provide a more favorable basis for the nutritional assessment,treatment and prognostic prediction of cancer patients.展开更多
Background:There is an unmet need for accurate non-invasive methods to diagnose non-alcoholic steatohepatitis(NASH).Since impedance-based measurements of body composition are simple,repeatable and have a strong associ...Background:There is an unmet need for accurate non-invasive methods to diagnose non-alcoholic steatohepatitis(NASH).Since impedance-based measurements of body composition are simple,repeatable and have a strong association with non-alcoholic fatty liver disease(NAFLD)severity,we aimed to develop a novel and fully automatic machine learning algorithm,consisting of a deep neural network based on impedance-based measurements of body composition to identify NASH[the bioeLectrical impEdance Analysis foR Nash(LEARN)algorithm].Methods:A total of 1,259 consecutive subjects with suspected NAFLD were screened from six medical centers across China,of which 766 patients with biopsy-proven NAFLD were included in final analysis.These patients were randomly subdivided into the training and validation groups,in a ratio of 4:1.The LEARN algorithm was developed in the training group to identify NASH,and subsequently,tested in the validation group.Results:The LEARN algorithm utilizing impedance-based measurements of body composition along with age,sex,pre-existing hypertension and diabetes,was able to predict the likelihood of having NASH.This algorithm showed good discriminatory ability for identifying NASH in both the training and validation groups[area under the receiver operating characteristics(AUROC):0.81,95%CI:0.77-0.84 and AUROC:0.80,95%CI:0.73-0.87,respectively].This algorithm also performed better than serum cytokeratin-18 neoepitope M30(CK-18 M30)level or other non-invasive NASH scores(including HAIR,ION,NICE)for identifying NASH(P value<0.001).Additionally,the LEARN algorithm performed well in identifying NASH in different patient subgroups,as well as in subjects with partial missing body composition data.Conclusions:The LEARN algorithm,utilizing simple easily obtained measures,provides a fully automated,simple,non-invasive method for identifying NASH.展开更多
Spinal disease is an important cause of cervical discomfort,low back pain,radiating pain in the limbs,and neurogenic intermittent claudication,and its incidence is increasing annually.From the etiological viewpoint,th...Spinal disease is an important cause of cervical discomfort,low back pain,radiating pain in the limbs,and neurogenic intermittent claudication,and its incidence is increasing annually.From the etiological viewpoint,these symptoms are directly caused by the compression of the spinal cord,nerve roots,and blood vessels and are most effectively treated with surgery.Spinal surgeries are primarily performed using two different techniques:spinal canal decompression and internal fixation.In the past,tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area.However,this method has several disadvantages because of its subjectivity.Therefore,it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition,improve the accuracy of safe area location,and avoid surgical injury to tissues.Aside from traditional imaging methods,surgical sensing techniques based on force,bioelectrical impedance,and other methods have been gradually developed and tested in the clinical setting.This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.展开更多
Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedem...Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.展开更多
基金Supported by The Fundacao de Amparo a Pesquisa do Estado de Sao Paulo,Nos.2011/13243-3,2012/15677-3[GB]
文摘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.
基金supported by grants from the National Natural Science Foundation of China(81770532,WDD)the Jiangsu Province Medical Foundation for Youth Talents(QNRC2016901,WDD)。
文摘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.
文摘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.
文摘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.
基金supported by the National Natural Science Foundation of China(No:81673167 to Hongxia Xu)the Chongqing Technology Innovation and Application Dem on stration Project for Social Livelihood(cstc2018jscx-msybX0094,to Jie Liu).
文摘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.
基金This research was supported by the Special Fund for Agro-scientific Research in the Public Interest(20120302)the Program of the Co-Construction with Beijing and the Specialized Research Fund for the Doctoral Program of Higher Education(20130008110035).
文摘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.
文摘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.
文摘It is estimated in Western industrialized countries that inflammatory bowel disease(IBD)has a prevalence of 1 for every 200 inhabitants.In the past,the fat mass disproportionate increase in relation to the fat-free mass was considered uncommon in patients with IBD,due to the observation of the disease being more common with weight loss and malnutrition.However,more in-depth investigations demonstrate that the fat/lean mass disproportion stands out both in prevalence in patients with new diagnoses of ulcerative colitis or Crohn's disease as well as a factor of poor prognosis to the natural evolution of the disease or to the therapeutic response.Another important aspect associated with obesity in IBD is the increased risk of drug clearance[including anti-tumor necrosis factor(TNF)and anti-integrin agents],resulting in short half-life and low trough drug concentrations,since the levels of TNF secreted by adipocytes sequester anti-TNF agents,which could result in suboptimal response to biologics.In view of these characteristic aspects of the inflammatory process of IBD,the identification of cellular functioning is necessary,which can be associated with the staging of the underlying disease,biochemical parameters,and body composition,helping as an indicator for a more accurate clinical and nutritional conduct.
基金supported by National Special Program for Science&Technology Basic Resources Investigation of China[Grant Number:2017FY101100 and 2017FY101103]。
文摘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.
基金the Project of Health and Family Planning Commission of Jilin Province(Grant 2017J064 to JW.C)the Project of Jilin Provincial Department of Education(Grant JJKH20190020KJ to JW.C)。
文摘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.
基金Science and Technology Department of Jilin Provincial(No.3D5204167428 for Dr.Nan Ya Wang).
文摘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.
文摘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.
基金This research was funded by Defiance Brands Inc,Nashville,TN,USA.
文摘Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved hydration,improved upper airway health and increased heart rate variability.Two groups of Thoroughbred racehorses matched for physiological,training and racing attributes were studied for 4 weeks.One group(n=17)received 10 L(about 15%)of their daily water as SW(followed by ad libitum filtered deep well water)and the control group(n=15)only filtered deep well water.Blood samples and bioelectrical impedance analysis(BIA)measures were obtained at baseline,2 and 4 weeks.Hydration was assessed using BIA.The upper airway was assessed by nasopharyngeal endoscopy at baseline and weekly within 60 minutes of breezing.On weekly breeze days heart rate was recorded at rest,during exercise and recovery and data were analysed for heart rate variability.Compared to controls,horses drinking SW showed increased hydration improved upper airway health post-breezing and increased heart rate variability.It is concluded that drinking 10 L daily of SW increased hydration and may have conferred some wellness benefits.
基金founded by Wu Jieping Medical Foundation(No.320.6750.19001).
文摘Bioelectrical impedance analysis(BIA)is a noninvasive and reproducible technique for assessing changes in body composition and nutritional status.The phase angle(PA),a major parameter of BIA,is one of the most sensitive indicators used to detect malnutrition in patients,and is also a prognostic marker in various clinical diseases.The incidence of malnutrition in cancer patients is high,and malnutrition seriously affects the treatment process and prognosis of patients.Reasonable and effective nutritional interventions are therefore of great significance for cancer patients.Compared with traditional nutritional assessment tools,the PA has unique advantages in the nutritional assessment,efficacy monitoring and prognostic prediction of patients with malignant tumors,and it has broad application prospects in clinical practice.This article reviews the research progress on the application of the PA in patients with malignant tumors to provide clinicians with a tool to predict malnutrition,and provide a more favorable basis for the nutritional assessment,treatment and prognostic prediction of cancer patients.
基金supported by grants from the National Natural Science Foundation of China(82070588)High Level Creative Talents from Department of Public Health in Zhejiang Province(S2032102600032)+2 种基金Project of New Century 551 Talent Nurturing in Wenzhousupported in part by grants from the University School of Medicine of Verona,Verona,Italysupported in part by the Southampton NIHR Biomedical Research Centre(IS-BRC-20004),UK.
文摘Background:There is an unmet need for accurate non-invasive methods to diagnose non-alcoholic steatohepatitis(NASH).Since impedance-based measurements of body composition are simple,repeatable and have a strong association with non-alcoholic fatty liver disease(NAFLD)severity,we aimed to develop a novel and fully automatic machine learning algorithm,consisting of a deep neural network based on impedance-based measurements of body composition to identify NASH[the bioeLectrical impEdance Analysis foR Nash(LEARN)algorithm].Methods:A total of 1,259 consecutive subjects with suspected NAFLD were screened from six medical centers across China,of which 766 patients with biopsy-proven NAFLD were included in final analysis.These patients were randomly subdivided into the training and validation groups,in a ratio of 4:1.The LEARN algorithm was developed in the training group to identify NASH,and subsequently,tested in the validation group.Results:The LEARN algorithm utilizing impedance-based measurements of body composition along with age,sex,pre-existing hypertension and diabetes,was able to predict the likelihood of having NASH.This algorithm showed good discriminatory ability for identifying NASH in both the training and validation groups[area under the receiver operating characteristics(AUROC):0.81,95%CI:0.77-0.84 and AUROC:0.80,95%CI:0.73-0.87,respectively].This algorithm also performed better than serum cytokeratin-18 neoepitope M30(CK-18 M30)level or other non-invasive NASH scores(including HAIR,ION,NICE)for identifying NASH(P value<0.001).Additionally,the LEARN algorithm performed well in identifying NASH in different patient subgroups,as well as in subjects with partial missing body composition data.Conclusions:The LEARN algorithm,utilizing simple easily obtained measures,provides a fully automated,simple,non-invasive method for identifying NASH.
基金This work was supported by the Beijing Natural Science Foundation(No.LI 82068)。
文摘Spinal disease is an important cause of cervical discomfort,low back pain,radiating pain in the limbs,and neurogenic intermittent claudication,and its incidence is increasing annually.From the etiological viewpoint,these symptoms are directly caused by the compression of the spinal cord,nerve roots,and blood vessels and are most effectively treated with surgery.Spinal surgeries are primarily performed using two different techniques:spinal canal decompression and internal fixation.In the past,tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area.However,this method has several disadvantages because of its subjectivity.Therefore,it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition,improve the accuracy of safe area location,and avoid surgical injury to tissues.Aside from traditional imaging methods,surgical sensing techniques based on force,bioelectrical impedance,and other methods have been gradually developed and tested in the clinical setting.This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.
文摘Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.
