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Objective To observe the relation of phase angle (PA) measured by bioelectrical impedance method with nutritional status of patients with primary liver cancer, and to explore its influence on clinical outcomes. Methods We collected 120 inpatients with primary liver cancer for nutritional risk screening, patient-generated subjective nutrition assessment(PG-SGA), anthropometry, biochemical examination and body composition analysis. According to the phase angle, the patients were divided into low PA group and normal PA group. The correlation between PA and nutrition-related indicators was analyzed. The survival and complications of the two groups were compared after 1-year follow-up. Results There were 56.7% (68/120) of primary liver cancer patients with lower PA. TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI in low PA group were lower while ECW/TBW was higher than those in normal PA group (all P < 0.05). The correlation analysis showed that PA was negatively correlated with ECW/TBW (P < 0.05), but positively correlated with TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI (all P < 0.05). Low PA was significantly associated with nutritional risk, deterioration of liver function, progress of liver cancer staging and severe malnutrition (all P < 0.05). During the follow-up period, the mortality of the low PA group was higher than that of the normal PA group (P < 0.05). The risk of death in the low PA group increased by 2.738 times (OR=3.738, 95%CI: 1.465-9.535). Conclusion Phase angle is an economic and effective index to reflect the nutritional status of patients with primary liver cancer, and closely related to the risk of death. Phase angle measurement is helpful for assessing nutritional status and predicting clinical outcome of patients with primary liver cancer.

Malnutrition, sarcopenia, and osteoporosis are common nutrition-related complications in patients with liver cirrhosis. Sarcopenia is an important manifestation of malnutrition, while malnutrition and sarcopenia are risk factors for osteoporosis. There is a close relationship among them, and they all have adverse effects on the clinical outcomes and prognosis of patients with liver cirrhosis. Therefore, it is necessary to identify them as early as possible and take active measures for prevention and treatment. Insufficient intake of nutrients, metabolic disorders, abnormal hormone levels, and lack of physical activity all contribute to the development of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis. In addition, medications commonly used in the treatment of liver diseases, such as glucocorticoids and some antiviral drugs, may have potential impact on bone metabolism, which needs to be taken seriously in clinical practice. Reasonable nutritional intervention, appropriate exercise, and treatment of underlying diseases are the basis of the prevention and treatment of malnutrition, sarcopenia, and osteoporosis. Some targeted drugs can improve these nutrition-related complications, which needs to be confirmed by further studies.

Supplemental data for "IL-17A promotes lung fibrosis through impairing mitochondrial homeostasis in type II alveolar epithelial cells"

Most commercial off-the-shelf(COTS) personal computer operating systems can't provide information protection strong enough. Since these systems together with various applications running on them are so widely adopted, they won't be replaced in near future. A practical solution for their vulnerabilities is to harden them. In this paper, a security enhancement architecture for COTS operating system is proposed. It consists of five key components: information flow hook(IFH), information flow parser(IFP), policy decision engine(PDE), application supporting layer(ASL), and policy enforcement component. IFH and IFP work together to make the rest part of the architecture be operating system independent. By this way, the architecture is made a general framework for COTS operating system security enhancement. PDE is an abstract layer of different policies, it makes the architecture be able to support multiple security policies. ASL is introduced for compatibility purposes, it mediates conflictions between enforced security policies and existing applications. In practice, the architecture can be implemented using Interposition technology thus requires neither source code nor binary level modification of the preexisting system.