Sarcopenia remains poorly managed in clinical practice due to the lack of simple and accurate screening tools. This study aimed to identify the cutoff values of the SARC-F questionnaire and Ishii's score using the variables age, grip strength, and calf circumference in older inpatients in China to compare the accuracy of the two methods and to explore their predictive ability for adverse outcomes (rehospitalization, falls, fracture, and death). Hospitalized patients (n=138) aged ≥60 years were included. The accuracy of the two tools was evaluated using the reference diagnosis recommended by the Asian Working Group on Sarcopenia (assessing patients with measurements of muscle mass, handgrip strength, and usual gait speed). Follow-up data were obtained by telephone and clinical visits combined with the inpatient medical record system after discharge for at least one year. The results showed that the SARC-F score reached the highest Youden's index when a score of 3 was set as the cutoff value. Ishii's score presented a higher accuracy than SARC-F (area under the receiver operating curve: 0.78 vs 0.64, P=0.01). The Kaplan-Meier survival analysis demonstrated a higher cumulative incidence of rehospitalization in sarcopenic individuals compared to non-sarcopenic individuals according to SARC-F (log-rank test, P<0.001). Cox analysis revealed that SARC-F was an independent risk factor for rehospitalization (adjusted hazard ratio: 4.23, 95%CI: 2.12-9.79, P<0.001). The SARC-F and Ishii's scores might facilitate the early detection of sarcopenia and help identify older adults at risk for adverse outcomes in clinical practice.

Objectives Unplanned readmissions severely affect a patient’s physical and mental well-being after kidney transplantation (KT), which is also independently associated with morbidity. A retrospective study was conducted to identify the incidence, causes and risk factors for unplanned readmission after KT among Chinese patients. Methods Patients who underwent KT were admitted to the organ transplant center of the Affiliated Hospital of University of Science and Technology of China (2017–2018). Medical records for these patients were obtained through the hospital information system (HIS). Results In 518 patients, the incidence of unplanned readmissions within 30 days ( n = 9) was 1.74%, and 90 days ( n = 64) was 12.35%. The one-year unplanned readmission rate was 22.59% ( n = 122). Overall, 122 patients were readmitted because of infection, renal events, metabolic disturbances, surgical complications, etc. Hemodialysis ( OR = 10.462, 95% CI: 1.355–80.748), peritoneal dialysis ( OR = 8.746, 95% CI: 1.074–71.238) and length of stay ( OR = 1.023, 95% CI: 1.006–1.040) were independent risk factors for unplanned readmissions. Conclusion Unplanned readmission rates increased with time after KT. Certain risk factors related to unplanned readmissions should be deeply excavated. Targeted interventions for controllable factors to alleviate the rate of unplanned readmissions should be identified.

Background Cystatin C (Cys) is considered to be a better marker than serum creatinine in assessing kidney function, predicting cardiovascular events, and all-cause mortality. It seems to be associated with nutritional status in the general population, but little is known about kidney transplant recipients (KTRs). This study aimed to explore the relationship between dietary balance index and serum Cys in KTRs. Material/Methods In a cross-sectional study, 215 KTRs completed an FFQ questionnaire and information on serum Cys. Dietary intake was assessed using the Food Frequency Questionnaire (FFQ). Dietary Balance Index 2016 (DBI-16) edition scores were calculated as an indicator of dietary quality. Data on the patient’s serum Cys were obtained through the hospital information system. Results The majority of KTRs were male (75.34%), 76.74% were aged 18–44 years, and 79.53% were abnormal serum Cys. Dairy (z=−2.161, P<0.05), meat (z=−2.578, P<0.05), and dietary diversity (z=−3.393, P<0.05) in the normal group were higher than those in the abnormal group, and the dietary quality distance (DQD) score ( t =−2.264, P <0.05) was lower than that in the abnormal group. After adjusting for confounders, a low-quality diet was a risk factor for maintaining the normal level of serum Cys (OR 3.022, 95% CI 1.263–7.231, P <0.05). Conclusions The present study suggested that KTRs with a high dietary quality might be associated with normal serum Cys levels. Dairy, meat, and varied diet seems to impact the serum Cys levels of KTRs. Dietary imbalances were prevalent among KTRs.

In order to explore the colorectal cancer during perioperative period based on the structure model of artificial neural network, and to provide reference for the selection of perioperative nursing measures for patients with colorectal cancer, the artificial neural network models of rectal colon cancer patients with different nutritional interventions based on biomedicine were established. 264 patients with rectal colon cancer and accelerated rehabilitation nutritional nursing group. There were 132 patients in each group who were given different nutritional intervention measures to compare the quality of life after nursing. The results suggested that artificial neural network had a certain value in predicting the impact of different nutritional interventions on patients’ quality of life. In addition, the initial anal ventilation time, initial anal defecation time, infusion time and hospitalization time of patients in accelerated rehabilitation nursing group were shorter than those in routine nursing group, and the incidence of abdominal distension after operation was significantly lower than that of routine nursing group (P < 0.05). The cancer-related fatigue (P < 0.05). To sum up, artificial neural network can adapt to the non-linear effect of the model and has a strong advantage in survival analysis. Accelerated rehabilitation nursing intervention measures can promote the rehabilitation of patients with rectal colon cancer during perioperative period and improve the overall quality of life, which is worthy of clinical reference.

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