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2024 Vol. 11, No. 5
Published: 2024-10-09
 
591 Cancer radiotherapy and nutritional therapy laying equal stress on basic nutrition and precision nutrition
Wu Han, Zhou Fuxiang
Malnutrition is a common comorbidity and complication in cancer patients undergoing radiotherapy. It can reduce the efficacy of radiotherapy increase adverse reactions to radiotherapy and even impact the patient 's survival time and quality of life. Nutritional therapy is crucial for cancer patients undergoing radiotherapy and it is of great significance to provide standardized and effective nutritional treatment for these patients. Nutritional therapy for cancer should be considered as first line and fundamental treatment integrated throughout the entire process of cancer treatment. It is essential for cancer patients to undergo comprehensive nutritional management throughout the "peri-radiotherapy period". Cancer is a metabolic disease and in addition to providing basic nutritional therapy to meet the basic energy protein and nutrient needs of cancer patients personalized and precise nutritional therapy should also actively explore aspects such as dietary regulation targeting tumor metabolism and immunonutrition. Cancer nutritional therapy is not only about supplementing energy and nutrients but also about regulating cancer metabolism and immunity and even improving survival rates. Both basic nutrition and precise nutritional therapy should be emphasized. Furthermore cancer patients endure various psychological and physiological impacts during their treatment. Multimodal integrated rehabilitation can synergistically enhance the patients' recovery making clinical rehabilitation integrated. Research is urgently needed to further explore the clinical application of multimodal integrated rehabilitation based on nutritional therapy in radiotherapy patients through large-scale randomized controlled trials.
2024 Vol. 11 (5): 591-596 [Abstract] ( 63 ) HTML PDF (870 KB)  ( 50 )
597 Nutrition strategy to depressive symptoms in cancer patients
Li Zhen, Hu Ming, Wu Jiang
Depressive symptoms are significantly more prevalent among cancer patients representing one of the most common psychological disorders in this population. These symptoms often diminish patients' enthusiasm for treatment thereby weakening the effectiveness of their care and posing obstacles to their clinical recovery which adversely affects their prognosis. This article aims to analyze the current epidemiological characteristics of depression in cancer patients comprehensively and systematically identify the risk factors closely associated with it. This article examines how various dietary patterns and specific nutrients subtly influence depressive symptoms highlighting the critical role of nutritional intervention in the prevention and alleviation of depression. Through scientific demonstration we emphasize the considerable potential of optimizing dietary structures and rationally supplementing nutrients as non-pharmacological therapies to enhance patients' psychological well-being and improve their quality of life. Additionally this article proposes several prospective directions for future research aiming to bridge existing knowledge gaps foster the cross-integration of nutrition psychology oncology and other disciplines and explore more precise and effective strategies for clinical depression management. In summary this article serves not only as an in-depth review of depressive symptoms in cancer patients but also as a strong advocacy for the potential application of nutritional therapy within the realm of mental health. It is hoped that this work will contribute valuable insights and support to promote the overall health of cancer patients.
2024 Vol. 11 (5): 597-601 [Abstract] ( 38 ) HTML PDF (906 KB)  ( 19 )
602 Interpretation of ESPEN practical guideline home enteral nutrition in 2022
1Yu Yuan,1Liu Miao,2Cong Minghua
Patients who are at high nutritional risk or are malnourished whose nutritional needs are not met by oral pathways and whose gastrointestinal function is normal should be treated with enteral nutrition therapy. If the patient's nutritional intake is likely to be qualitatively or quantitatively inadequate for a week or more enteral nutrition support therapy may be administered at home under the guidance of a professional nutrition support team. The implementation of home enteral nutrition can effectively reduce the incidence of complications and hospital stay save medical costs improve the clinical outcome of patients and have significant clinical and cost effectiveness. With the development of medical treatment more patients are willing to receive long-term enteral nutrition support at home. In 2022 the European Society for Clinical Nutrition and Metabolism ESPEN published the latest edition of the practical guideline Home enteral nutrition which build on the guidelines published in 2019 providing the latest available evidence and expert opinion and the content is presented in the form of a decision flow chart to make it more intuitive and refined. The guidelines put forward 61 recommendations on 5 aspects indications for HEN equipment evaluation for HEN recommended products for HEN monitoring and termination of HEN and structural requirements for HEN providing very important reference opinions for guiding patients to conduct home enteral nutrition therapy. This article interprets the guidelines recategorize recommendations and aims to improve understanding and provide guidance for family enteral nutrition practice.
2024 Vol. 11 (5): 602-614 [Abstract] ( 40 ) HTML PDF (4188 KB)  ( 40 )
615 Advances and mechanisms of physical activity in cancer patients
Ren Qi, Zhang Fengmin, Zhuang Chengle
The high mortality and poor prognosis of malignant tumors pose a serious threat to the postoperative health of cancer patients. Traditional treatments such as surgery radiation therapy and chemotherapy remain essential yet patients still face risks of tumor recurrence post-surgery alongside potential adverse effects on quality of life compromised physical functions and significant anxiety and depression. In this context exercise therapy has emerged as one of the most accessible and convenient measures to improve prognosis for cancer patients. Recent oncological rehabilitation guidelines frequently emphasize the importance of exercise therapy. Physical activity enhances cardiorespiratory function and protein synthesis improves physiological skills and increases physiological reserves. Moreover it helps regulate metabolism and immune balance creating an internal environment conducive to combating tumors. Whether patients are in the perioperative period undergoing radiotherapy or chemotherapy or dealing with conditions like cachexia or sarcopenia exercise therapy is a crucial rehabilitative approach. By selecting scientifically sound exercise protocols and controlling appropriate frequency and intensity significant improvements in nutritional status can be achieved. This aids patients in better completing their anti - tumor treatments reducing complications improving quality of life and even extending survival. This review summarizes the clinical advancements of exercise therapy in cancer patients.
2024 Vol. 11 (5): 615-620 [Abstract] ( 26 ) HTML PDF (1133 KB)  ( 28 )
621 Clinical nutrition advances in 2023
1Sun Jie,1Gao Hui,1,2Yao Ying
Clinical nutrition is a discipline that aims to promote health prevent and treat diseases by scientifically assessing nutritional needs and adjusting diet and nutrient intake. The clinical nutrition emphasizes the role of diet in maintaining health and treating disease. Now remarkable progress in clinical nutrition attributing to continuous advances in science and technology combined with a deeper understanding in nutrients􀆶 function and metabolism are providing a new impetus and novel ways to prevent and treat various diseases. As the expanding of clinical nutrition research and application nutritional intervention strategies have evolved from traditional dietary recommendations to more refined and individualized management. The utilization of emerging scientific technologies such as genomics and microbiome has enabled to tailor nutritional intervention plans. Moreover nutritional monitoring and management models are also revolutionizing owing to digital health technologies. Emphasized the integration of scientific research and evidencebased medicine modern clinical nutrition aims to update and refine nutritional guidelines through large - scale clinical trials and epidemiological studies. Thus by summarizing the recent progress in nutritional diagnosis and therapy the purpose of this article is to provide a new perspective and strategy for the prevention and therapy of various diseases.
2024 Vol. 11 (5): 621-628 [Abstract] ( 43 ) HTML PDF (863 KB)  ( 48 )
629 Nutritional therapy guidelines for radiotherapy patients (2024 Edition)
Chinese Society of Nutrition Oncology, Chinese Society for Parenteral and Enteral Nutrition
Radiotherapy is a key method in the treatment of malignant tumors which has significant benefits. It not only effectively reduces the burden of tumors and relieves related symptoms but also deeply affects the nutritional status of patients. However the process of radiotherapy complexly interferes with the intake digestion absorption and metabolism of nutrients which can easily lead to or aggravate malnutrition becoming a common complication of radiotherapy patients. In view of the significant negative impact of malnutrition on prognosis and quality of life it is essential to implement systematic and standardized nutritional assessment and intervention for radiotherapy patients. Therefore nutritional risk screening 2002 NRS 2002 scale is recommended as the preferred screening tool because of its scientific and practical nature. However the patient-generated subjective global assessment PG-SGA plays an important role in nutritional assessment due to its comprehensiveness and sensitivity and provides a basis for personalized nutritional intervention. In view of the dynamic changes in nutritional status of patients we advocate flexible strategies such as timely adjustment of treatment pathways optimization of enteral and parenteral nutrition support personalized energy and protein requirements setting reasonable supplementation of immune nutrients and encouraging patients to participate in physical activity. These comprehensive measures are aimed at comprehensively improving the nutritional status of patients during the perioperative period of radiotherapy reducing the adverse reactions of radiotherapy improving the tolerance of patients and enhancing the sensitivity of tumor cells to radiotherapy so as to optimize the therapeutic effect. Both in the short and long term they are expected to significantly improve the efficacy and ultimately improve the overall quality of life of patients.
2024 Vol. 11 (5): 629-637 [Abstract] ( 143 ) HTML PDF (1637 KB)  ( 89 )
638 The prevalence of sarcopenia in hospitalized cancer patients in China
1Song Chunhua，1Cheng Haoqing，2Cui Jiuwei，etc.
Objective This study aims to investigate the prevalence of sarcopenia specifically in Chinese patients with malignant tumors. Method A total of 61 627 patients with 19 types of malignant tumors from 86 grade-A hospitals from July 2013 to December 2023 were included in the INSCOC database of the Chinese Tumor Nutrition Cohort Study. The diagnostic criteria for sarcopenia provided by the Asian Working Group on Sarcopenia AWGS in 2019 were used. Chi-square test or Fisher exact test was used to compare the prevalence of sarcopenia in patients with different population characteristics. Result The prevalence of sarcopenia in cancer patients was 18. 1%. The prevalence of sarcopenia varied with tumor type TNM stage age gender administrative area and treatment. The prevalence of sarcopenia was higher in patients with digestive system cancers and the highest prevalence was found in patients with pancreatic cancer 32. 4% 311 / 961 . The prevalence of sarcopenia increased with the increase of TNM stage P< 0. 05 . The prevalence of sarcopenia was the highest in patients over 70 years old 34. 7% 3510 / 10 129 . The prevalence of sarcopenia in female cancer patients was higher than that in male patients 16. 1% 5544 / 34 381 vs 20. 7% 5631 / 27 246 P<0. 05 . The lowest prevalence was found in the Northeast region 14. 7% 2398 / 16 300 . Patients who received surgical treatment had the highest prevalence 22. 1% 1635 / 7412 . In addition in some tumor types there were significant differences in the prevalence of sarcopenia among patients with different medical insurance types occupation education level ethnicity and place of residence. Patients with low education level and farmers had a higher risk of sarcopenia. Conclusion This study is the first to report the incidence of sarcopenia in tumor patients on a large scale with a prevalence of 18%. Patients with digestive system cancers elderly farmers low education level and advanced tumor are high risk groups for sarcopenia.
2024 Vol. 11 (5): 638-650 [Abstract] ( 62 ) HTML PDF (2578 KB)  ( 10 )
651 The relationship between lymphocyte-to-C-reactive protein ratio and prognosis in patients with non-small cell lung cancer
1Liu Yan, 2Peng Simin, 3Yang Jinrong, 4Zhang Yusong, 1Chen Guochong, 1Qin Liqiang
Objective Systemic inflammatory response is closely related to tumor progression. We aimed to investigate the prognostic value of ratio of lymphocyte to C-reactive protein ratio LCR for overall survival OS in patients with non-small cell lung cancer NSCLC . Method 422 NSCLC patients were enrolled in this study. An outcome-oriented Method was used to determine the most appropriate cut - off value of LCR. The participants were divided into two groups a low - LCR group and a high - LCR group. Survival curves were generated using the Kaplan-Meier Method and compared using the log-rank test. We performed subgroup analysis according to histological type adenocarcinoma vs squamous cell carcinoma and TNM stage Ⅰ-Ⅲ vs Ⅳ . Cox proportional hazard regression model was used to calculate hazard ratio HR and 95% confidence interval CI . Moreover We performed subgroup analysis and interaction analysis based on patient characteristics and Cox product interaction analysis to investigate the impact of the interaction between patient characteristics and LCR on the prognosis of NSCLC patients. Result The Kaplan-Meier analysis revealed that patients with high LCR had significantly improved OS P<0. 001 . Patients with high LCR also showed a significantly improved OS P<0. 001 after stratified by histological type and TNM stage. The Cox multivariate analysis showed that patients with high LCR HR= 0. 45 95%CI = 0. 34-0. 61 P<0. 001 had favorable prognoses when compared with those with the lowest LCR. Gender P = 0. 012 smoking P= 0. 002 and histological type P = 0. 012 significantly interacted with LCR indicating that high LCR was a good indicator for male former/ current smokers squamous carcinoma or adenocarcinoma patients. Conclusion High LCR may be associated with a favorable prognosis in NSCLC patients.
2024 Vol. 11 (5): 651-658 [Abstract] ( 21 ) HTML PDF (2866 KB)  ( 12 )
659 Longitudinal study of prognostic nutritional index curve in patients with primary liver cancer
1Xu Yuhong,2Ju Lingling,1Song Tingting, 1Wang Yuanyuan
Objective To explore the change track of prognostic nutritional index in patients with primary liver cancer and analyze its influencing factors. Method 140 patients diagnosed with primary liver cancer who underwent surgical treatment in the Third People's Hospital of Nantong from January 2021 to December 2023 were selected as the study objects. General data questionnaire and nutritional index were used to investigate within one week after surgery T1 after the first radiotherapy T2 after 15 radiotherapy T3 after 30 radiotherapy or after the last radiotherapy T4 . Latent category growth model and single factor analysis were used for data processing. Result The prognostic nutritional index curve of patients with primary liver cancer was identified to be divided into three potential categories and the average probability of patients in each category belonging to each potential category was 0. 946 0. 950 0. 944 respectively. The three categories were malnutrition plus recombination 28. 3% good nutrition 55. 8% and improved malnutrition 15. 9% . Different locus categories were age χ 2 = 15. 025 P = 0. 005 marital status χ 2 = 7. 407 P = 0. 025 education level χ 2 = 16. 364 P= 0. 012 liver cancer grade χ 2 = 12. 004 P= 0. 017 chronic disease χ 2 = 7. 887 P= 0. 012 the difference was statistically significant. Conclusion By investigating the change characteristics of prognostic nutritional index in patients with primary liver cancer from postoperative to the end of radiotherapy this study identified three different curve trajectories and there were differences in the curve trajectories of prognostic nutritional index in patients. Clinical staff should pay close attention to patients with primary liver cancer caused by malnutrition and recombination timely identify high-risk patients with malnutrition and provide active and targeted nutritional support to reduce the occurrence of adverse events caused by malnutrition as much as possible.
2024 Vol. 11 (5): 659-664 [Abstract] ( 27 ) HTML PDF (1166 KB)  ( 17 )
665 Correlation between prognostic nutritional index and insulin resistance in male patients with fatty liver disease
1,2Jiang Qilan,1,2Su Wenyi,1,2Han Ming,1,2Liao Xin,2Luo Gang,1,3Wang Min
Objective To investigate the correlation between prognostic nutritional index PNI and insulin resistance IR in male patients with fatty liver disease and to provide a scientific basis for the clinical management of patients with fatty liver disease. Method A cross-sectional survey Method was used to analyze the data from male individuals who underwent health examinations at the Health Management Center of the Affiliated Hospital of Southwest Medical University between January 2019 to December 2021 and fatty liver was diagnosed based on abdominal ultrasound results. IR was defined according to the triglyceride-glucose index TyG and PNI scores were categorized into tertiles Q1 PNI < 55. 36 Q2 55. 36 ≤ PNI < 58. 56 Q3 PNI ≥58. 56 . Logistic regression analysis was employed to examine the association between PNI and IR with the Q1 group serving as the reference. Result A total of 714 male patients with fatty liver were included in this study of which 490 had IR 68. 63% . The results of univariate and multivariate logistic regression analysis showed that PNI is a risk factor for IR in male patients with fatty liver disease. Univariate logistic regression analysis compared with the PNI < 55. 36 group the risk of IR when PNI levels were 55. 36 ≤ PNI < 58. 56 and PNI ≥ 58. 56 increased by 1. 717 times and 2. 264 times greater respectively. Multivariate logistic regression analysis after adjusting for confounding factors such as body mass index waist circumference visceral fat area and total cholesterol compared with the PNI < 55. 36 group the risk of IR when PNI levels were 55. 36≤ PNI < 58. 56 and PNI≥58. 56 increased by 1. 694 and 1. 710 times respectively. Conclusion PNI may serve as a useful indicator for assessing the risk of IR in male patients with fatty liver and may potentially be a predictor of IR onset.
2024 Vol. 11 (5): 665-670 [Abstract] ( 25 ) HTML PDF (858 KB)  ( 13 )
671 Correlation analysis of nutritional risk index serum ferritin soluble E cadherin and prognosis of adult patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation
Wang Yuanyuan, Ma Jingjing, Wang Lihong, Zhou Qian, Jiang Tingting
Objective To investigate the correlation between nutritional risk index NRI serum ferritin SF soluble E cadherin SE-CAD and prognosis of adult patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. Method A total of 119 patients with AML who received allogeneic hematopoietic stem cell transplantation in the Second Affiliated Hospital of PLA Air Force Medical University from January 2019 to December 2021 and were followed up until December 2023 were selected as the study subjects and 60 healthy subjects were selected as the control group during the same period. The changes of NRI SF and SE-CAD were compared. Result The NRI of experimental group was lower than that of control group while SF and SE-CAD were higher than that of control group P < 0. 05 . There were significant differences in NRI SF and SE-CAD among different WBC count hemoglobin bone marrow original cell ratio and FAB classification P < 0. 05 . White blood cell count hemoglobin bone marrow original cell ratio and FAB classification were negatively correlated with NRI and SF but positively correlated with SE-CAD and NLR P < 0. 05 . White blood cell count hemoglobin bone marrow original cell ratio and FAB classification were negatively correlated with NRI r = -0. 237 -0. 179 -0. 357 -0. 258 P<0. 05 but positively correlated with SF r = 0. 236 0. 212 0. 190 0. 180 P<0. 05 and SE-CAD r = 0. 328 0. 278 0. 302 0. 256 P<0. 05 . The decrease of NRI and the increase of SF and SE-CAD were independent influencing factors for 3 -year progression - free survival and overall survival of AML patients after surgery P < 0. 05 . The AUC values of NRI SF SE-CAD and three combinations in predicting the prognosis of AML patients were 0. 725 0. 755 0. 756 0. 843 P<0. 05 . Conclusion The abnormal decrease of NRI and the abnormal increase of SF and SE-CAD in patients with acute myeloid leukemia may have adverse effects on prognosis.
2024 Vol. 11 (5): 671-676 [Abstract] ( 18 ) HTML PDF (1239 KB)  ( 26 )
677 An observational study of sarcopenia and body fat level in cirrhotic patients
1,2Han Ming,1,2Jiang Qilan,1,2Su Wenyi,2Deng Mingming,2Luo Gang,1,3 Wang Min
Objective To analyze muscle and body fat levels in cirrhotic patients as well as investigate the association between liver disease severity and muscle and body fat in patients with cirrhosis. Method All study participants were cirrhosis patients who were hospitalized at Southwest Medical University's Affiliated Hospital from November 2022 to November 2023. A cross-sectional study was used to collect data on cirrhotic patients' general condition blood routine biochemical tests anthropometric measurements etc. Measurement of skeletal muscle index L3 -SMI visceral fat area VFA and subcutaneous fat area SFA of abdominal CT at the level of the 3rd lumbar vertebrae using Sliceomatic 5. 0 image analysis software. The Geriatric Nutritional Risk Index GNRI was analyzed. VFA and SFA were correlated with L3 - SMI triceps skinfold thickness TSF and mid - arm circumference MAC respectively. To compare the levels of body fat and muscle measured by CT in subgroups with different Child-Pugh classifications and MELD scores. Result A total of 203 patients with liver cirrhosis were included 86 patients with sarcopenia 42. 4% and 117 patients with non-sarcopenia 57. 6% . Body mass index BMI hand grip strength HS MAC TSF calf circumference CC VFA SFA visceral adiposity index VATI and subcutaneous adiposity index SATI were lower in patients with cirrhosis combined with sarcopenia than in patients with non-sarcopenia P<0. 05 . VFA correlating most strongly with MAC r = 0. 595 P<0. 001 and SFA correlating most strongly with TSF r = 0. 753 P<0. 001 . Child-Pugh score grade C had lower VFA SFA VATI and SATI than Child-Pugh score grade A versus B P<0. 05 L3-SMI was not statistically different between groups and all of the above indicators were lower in the MELD score > 11 subgroup than in the MELD score ≤11 subgroup P < 0. 05 and L3 - SMI was again not statistically different between groups. Conclusion When sarcopenia occurred in patients with cirrhosis body fat levels also decreased and decreased with increasing disease severity but no significant changes in muscle levels were observed.
2024 Vol. 11 (5): 677-682 [Abstract] ( 29 ) HTML PDF (851 KB)  ( 20 )
683 Analysis of risk factors and Bayesian network model for the survival of patients with primary hepatic cancer
1Liu Sainan,2Zhao Heping,1Wei Manzhen,3Huang He
Objective The complex network relationship among risk factors of primary hepatic cancer PHC was deeply studied by Bayesian network model and investigate the risk factors that affect the 30-month survival. Method The clinical data of 363 patients with PHC from October 2016 to November 2020 in the First Hospital of Shanxi Medical University were retrospectively analyzed. Through follow-up surveys we have learned about the PHC patients' survival status etc. The survival was counted in months starting from the time of initial diagnosis and the follow-up surveys ended in October 2022. Based on literature reports and in combination with the average survival of PHC patients in this study 29. 6 months a final decision was made to select 30 months as the research node for survival. The related factors affecting the 30 - month survival of PHC patients were analyzed using both univariate and multivariate logistic regression. Additionally a Bayesian network model was established to further explore the complex network relationship among the risk factors for survival in PHC patients and to calculate the conditional probability among the factors. The effectiveness of the model was verified by receiver operating characteristic and calibration plot. Result Among the 363 patients with PHC 167 patients had a survival of < 30 months 46. 01% . The results of the univariate analysis showed significant statistical differences between the two groups of patients in terms of γ-glutamyl transferase γ-GT levels tumor size and the occurrence or absence of distant metastasis. The results of the multivariate logistic regression analysis revealed that γ-GT >40 U/ L tumor size > 3 cm and distant metastasis were risk factors for 30-month survival node of PHC patients P<0. 05 for all . The Bayesian network model showed that for PHC patients tumor size γ-GT levels and the occurrence or absence of distant metastasis were direct risk factors that affected their 30-month survival while tumor count and age were indirect risk factors that also influenced their 30-month survival. The conditional probability distribution table showed that tumor size >3 cm γ-GT >40 U/ L and distant metastasis in patients with PHC had the highest probability of survival <30 months 98. 408% . Conclusion The tumor size >3 cm γ-GT level >40 U/ L and distant metastasis are the risk factors affecting the 30-month survival of PHC patients. Age have a indirect relationship with the 30-month survival of PHC patients by affecting tumor size and the occurrence or absence of distant metastasis.
2024 Vol. 11 (5): 683-690 [Abstract] ( 19 ) HTML PDF (1435 KB)  ( 20 )
691 Construction and validation of hyperuricemia risk model in diabetic kidney disease patients
1Gu Li,2Xue Song,1Wang Ping
Objective To investigate the incidence and risk factors of hyperuricemia HUA in patients with diabetic kidney disease DKD then construct a nomogram predictive model to guide clinical practice. Method A retrospective summary was conducted on 219 DKD patients diagnosed in our hospital from January 2019 to June 2022 as training set. After admission they were divided into HUA group n = 102 and non-HUA group n = 117 according to the definition of HUA. Additionally 105 DKD patients from July 2022 to July 2023 were selected as validation set. The general clinical characteristics of patients and average blood biochemical values during the past 3 months were recorded then univariate and Logistic regression analysis was to analyze the risk factors to HUA in DKD patients and a nomogram predictive model was established. Result It showed that BMI OR = 1. 782 HbA1c OR = 2. 601 and hyperlipidemia OR = 1. 669 were risk factors to HUA while eGFR OR = 0. 606 was a protective factor. After establishing the nomogram the consistency indices of training set and validation set were calculated to be 0. 854 and 0. 802 respectively. The correction curve and ideal curve trends were basically consistent and the AUC calculated by ROC were 0. 867 95% CI = 0. 802 - 0. 923 and 0. 811 95%CI = 0. 745-0. 872 the clinical net benefit value was relatively high which all indicated that the model had good predictive ability. Conclusion DKD patients usually have a higher prevalence of HUA with high BMI high HbA1c and hyperlipidemia being risk factors while high eGFR as a protective factor. The construction of nomogram model has good value for guiding early and accurate screen of HUA high-risk groups in clinical practice.
2024 Vol. 11 (5): 691-697 [Abstract] ( 24 ) HTML PDF (1207 KB)  ( 16 )
698 Construction and validation of nomogram model for risk prediction of malnutrition in patients with liver cancer after radiotherapy and chemotherapy
Zhang Sha, Wang Jiuping, Yang Jin
Objective To investigate the influencing factors of malnutrition in patients with liver cancer after radiotherapy and chemotherapy and to build a risk prediction model based on the column graph. Method A total of 155 patients with liver cancer who received radiotherapy and chemotherapy in the First Affiliated Hospital of Air Force Military Medical University Xijing Hospital from June 2019 to December 2020 and were followed up until December 2023 were selected as the study objects. According to whether there was malnutrition after radiotherapy and chemotherapy they were divided into the malnourished group n = 49 and the non - malnourished group n = 106 . Compared with baseline data the risk factors of malnutrition after chemoradiotherapy were analyzed and the prediction model was constructed with a nomogram. Result There were significant differences in age TNM stage portal vein cancer thrombus differentiation degree lymph node metastasis swallowing dysfunction gastrointestinal symptoms albumin hemoglobin and other baseline data between the malnutrition group and the non -malnutrition group P< 0. 05 . Logistic regression analysis showed that portal vein cancer thrombus low differentiation lymph node metastasis swallowing dysfunction gastrointestinal symptoms ≥2 items albumin < 40 g / L hemoglobin <110 g / L were the risk factors for malnutrition in patients with liver cancer after radiotherapy and chemotherapy P< 0. 05 . ROC curve analysis showed that the ROC curve of the line chart prediction model for predicting nutritional malnutrition in liver cancer patients after chemoradiotherapy had an area under the curve AUC is 0. 936 the sensitivity is 0. 880 and the specificity is 0. 984. Conclusion Portal vein cancer thrombolus low differentiation lymph node metastasis swallowing dysfunction digestive tract symptom items≥2 albumin <40 g / L hemoglobin <110 g / L may have an impact on malnutrition after radiotherapy and chemotherapy in patients with liver cancer. The construction of a nomogram model based on these risk factors is of certain value in predicting malnutrition so as to formulate prevention and treatment measures.
2024 Vol. 11 (5): 698-705 [Abstract] ( 35 ) HTML PDF (1967 KB)  ( 21 )
706 The relationship between oxidative balance score and periodontitis a study based on National Health and Nutrition Examination Survey 2009-2012
1Wang Zechen,2Wang Shanshan,3Liu Jingsi,1Li Xingchao
Objective To explore the relationship between the oxidative balance score OBS and periodontitis. Method A retrospective analysis of clinical data from 5980 participants in the National Health and Nutrition Examination Survey NHANES database from 2009 to 2012 was conducted. We described the nonlinear relationship between OBS and the risk of periodontitis using restricted cubic splines. Logistic regression analysis was used to further describe the association between OBS and its components with the risk of periodontitis. Subgroup and interaction analyses were employed to explore this relationship across different groups. Result The study included 5980 patients with an average age of 51. 91 ± 14. 19 years. Of these 3301 participants had periodontitis. Compared to participants with a low OBS those with a high OBS had a reduced risk of periodontitis OR = 0. 80 95% CI = 0. 68-0. 93 . In patients with cancer this relationship was more pronounced OR = 0. 66 95% CI = 0. 48- 0. 89 . Subgroup and interaction analysis showed that the relationship between OBS and periodontitis was moderated by age with a stronger protective effect of OBS observed in older participants age ≥ 65 years OR = 0. 61 95%CI = 0. 43-0. 87 . Conclusion This study indicates that an increased OBS is associated with a reduced risk of periodontitis and this relationship is influenced by age. In older individuals a higher OBS has a stronger protective effect against the risk of periodontitis. Improving OBS-related diet and lifestyle may help reduce the occurrence and progression of periodontitis.
2024 Vol. 11 (5): 706-713 [Abstract] ( 20 ) HTML PDF (2187 KB)  ( 13 )
714 Effects of dietary anti-inflammatory index based nutritional support on immune function inflammatory factors cancerrelated fatigue and chemotherapy toxicity in lung cancer patients receiving chemotherapy
An Zhen, Wang Yan, Lei Jie, Gao Pei, Xiao Yu, Ma Jin
Objective To investigate the effects of dietary anti - inflammatory index on immune function inflammatory factors cancer-related fatigue and chemotherapy toxicity in lung cancer patients receiving chemotherapy. Method A total of 133 lung cancer patients who received chemotherapy in Tangdu Hospital of Air Force Military Medical University from February 2020 to December 2023 were selected as the study objects. According to different selection times 66 lung cancer patients who received conventional diet management from February 2020 to December 2021 were set as the control group. A total of 67 patients with lung cancer who received nutritional support based on dietary anti-inflammatory index from January 2022 to December 2023 were selected as the experimental group. The nutritional status immune function cancer fatigue and inflammatory factors before chemotherapy were compared and the toxic and side effects during chemotherapy were observed. Result At T1 T2 and T3 TP ALB PA CD4 + CD8 + CD4 + / CD8 + in observation group were higher than those in control group while hs-CRP and IL-6 were lower than those in control group P<0. 05 . At T3 time point the scores of physical fatigue emotional fatigue and cognitive fatigue in the Cancer Fatigue Scale CFS of the experimental group were lower than those of the control group P<0. 05 . The incidence of leukopenia thrombocytopenia nausea vomiting and diarrhea in observation group were lower than those in control group P<0. 05 . Conclusion Nutritional support based on dietary anti-inflammatory index can improve the nutritional status immune function and reduce cancer fatigue in lung cancer patients treated with chemotherapy which has a positive effect on improving the chemotherapy effect.
2024 Vol. 11 (5): 714-719 [Abstract] ( 31 ) HTML PDF (839 KB)  ( 19 )
720 Progress in the study of sarcopenia in patients with gynecologic malignancies
1Yin Haining,1Zha Yingjuan,1Ding Bo,2Zhu Di,1Shen Yang
Sarcopenia is a syndrome closely associated with decreased muscle mass and strength as well as decreased physical strength. As gynecologic malignancy surgery often requires extensive multi-organ surgical treatment which may also be accompanied by long-term radiotherapy and immunotherapy leading to a higher incidence of sarcopenia in gynecologic malignancy patients which seriously affects patients' somatic function treatment outcome and quality of life. At the same time there is increasing evidence that sarcopenia shortens progression - free survival increases toxic side effects of chemotherapy and the incidence of postoperative complications in patients with gynecologic malignancies. This article reviews sarcopenia in patients with gynecologic malignancies summarizing screening and assessment methods influencing factors and nonpharmacological interventions respectively with the aim of helping clinical staff to better understand sarcopenia in patients with gynecologic malignancies and providing a reference for the development of targeted sarcopenia management strategies.
2024 Vol. 11 (5): 720-726 [Abstract] ( 18 ) HTML PDF (2842 KB)  ( 31 )
727 Research progress on the anti-tumor mechanism of ketogenic diet
Zhang Li, Li Xiaoxue, Shu Qing, Tang Yuan
As a common disease endangering human health cancer has a high prevalence and disease burden in the world. At present surgery and chemoradiotherapy are the main treatment options for tumor. For early or locally advanced tumors surgery can remove the tumor completely providing the opportunity for radical treatment. Chemoradiotherapy has a good effect on local tumor control. However the efficacy of single operation chemoradiotherapy or combined operation with chemoradiotherapy may be limited by the drug resistance and clinical stage of patients and adjuvant therapy should be actively sought clinically. In recent years tumor metabolism and tumor nutrition have become the focus of clinical anti -tumor research. Ketogenic diet is a high fat and low sugar formula diet with reasonable proportion of protein and other nutrients which is widely used in the clinical treatment of brain diseases and metabolic diseases. Neoplasms can be regarded as metabolic diseases. On the one hand ketogenic diet therapy for tumor patients can satisfy the survival energy of normal cells on the other hand due to the restriction of ketone body utilization of tumor cells it can effectively inhibit their growth and metabolism and thus play an anti-tumor role. At present ketogenic diet can play an anti-tumor role by reducing glucose level inducing oxidative stress improving mitochondrial ketogenic body metabolism anti-inflammatory and enhancing immunity and other mechanisms. This article reviews the anti-tumor mechanism of ketogenic diet and the recent clinical research progress.
2024 Vol. 11 (5): 727-731 [Abstract] ( 41 ) HTML PDF (825 KB)  ( 24 )
732 A review on status of application of global leadership initiative on malnutrition criteria in cancer patient
1,2Zhang Zecheng,1Zhu Jun,1Qiao Yihuan,1,2Li Jipeng
Malignant tumors are one of the significant health issues faced by modern people. Malnutrition is a common complication of malignant tumors severely affecting the survival and prognosis of patients with malignant tumors. Timely nutritional intervention can help improve the prognosis of patients with malignant tumors. However the absence of a universally accepted "gold standard" for diagnosing malnutrition continues to pose challenges in clinical practice leading to confusion in both diagnosis and intervention. In 2018 the four major global nutrition societies jointly developed the Global Leadership Initiative on Malnutrition GLIM to unify the criteria for malnutrition. The diagnostic methods of GLIM criteria in the diagnosis of malnutrition in patients with malignant tumors have been progressively elucidated since its release and the diagnostic items have been gradually refined. The various diagnostic entries of the GLIM criteria are being progressively refined and clarified and their accuracy in diagnosing malnutrition and their predictive ability for clinical outcomes are being gradually verified. These advantages give the GLIM criteria the potential to become the gold standard for malnutrition diagnosis. Furthermore improved versions of the GLIM criteria as well as prognostic models based on the GLIM criteria are also being gradually developed. However studies using the GLIM criteria as a diagnostic criterion for malnutrition and to guide clinical nutritional interventions need to be further developed. This review systematically reviewed the application of GLIM criteria in malnourished patients with malignant tumors found a series of progresses and shortcomings in its clinical application and made outlooks for future application and concluded that GLIM criteria are of higher value in the clinical application of malnutrition in malnourished patients with malignant tumors.
2024 Vol. 11 (5): 732-740 [Abstract] ( 27 ) HTML PDF (917 KB)  ( 26 )
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