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2017 Vol. 4, No. 2
Published: 2017-06-09
 
130 Holistic nutrition therapy
SHI Han-ping
In order to better implement nutrition therapy, this article proposes a new mode, namely holistic nutrition therapy, extending traditional nutrition support in four aspects, including time (T), space (S), connotation (C) and denotation (D), to establish a TSCD multi-dimensional holistic nutrition therapy system. The time of nutrition therapy should be extended from hospitalization (H) to home stay (HS) and hospice (H), to establish a H-HS-H mode and implement lifelong (LL) nutrition therapy. The space of nutrition therapy should be extended from hospital (H) to community (C) and home (H), to establish a H-C-H mode and implement hierarchical nutrition therapy. The connotation of nutrition therapy should be extended from physical (P) to psychological (P), social (S) and spiritual (S), to establish a P-P-S-S mode and implement whole-person nutrition therapy. The denotation of nutrition therapy should be extended from disease treatment (T) to disease prevention (P) and disease rehabilitation (R), to establish a P-T-R mode and implement whole-course nutrition therapy. Holistic nutrition therapy can fully exert the core function of nutrition therapy in primary prevention, secondary prevention and tertiary prevention of chronic diseases (including cancer). Returning nutrition therapy to be the first-line therapy, prolonging patients’ survival time, improving the quality of life, saving medical costs and the social economic resources, and consequently improving the overall control and prevention for chronic diseases (including cancer) in our country.
2017 Vol. 4 (2): 130-135 [Abstract] ( 240 ) HTML PDF (1427 KB)  ( 155 )
144 Malignant bowel obstruction: a struggle of technology, emotion and hope
LV Jia-hua, LI Tao
Esophageal cancer was the fifth most common incident cancer and the fourth most lethal cancer in China. Radiation therapy was one of the most important treatment for esophageal cancer. The incidence of malnutrition in esophageal cancer is the highest in all malignant tumors. Because of swallowing obstruction due to primary tumor and radiation therapy related complications, the incidence of malnutrition in esophageal cancer patients treated with radiaotherapy was higher. Malnutrition might reduce the radiation sensitivity and precision, increase adverse reactions, affect the completion of the radiation, reduce the survival and quality of life. Nutritional therapy played an important role for the treatment and prognosis of esophageal cancer treated with radiotherapy. More and more oncologists payed attention to the nutritional therapy. For the esophageal patients with the risk of malnutrition, nutritional therapy was an indispensable part of combined modality therapy during radiotherapy. There was no criteria or specification about the method of nutritional therapy for esophageal cancer treated with radiotherapy. The nutritional therapy contained enteral nutrition, parenteral nutrition and partal enteral combined parenteral nutrition. This article mainly expounded the purpose, indications, optimal time, therapeutic approach, nutrients, nutrition related complication prevention and treatment and home nutritional therapy, which would give some reference and advice to the radiation oncologists when conducting nutritional therapy.
2017 Vol. 4 (2): 144-148 [Abstract] ( 303 ) HTML PDF (948 KB)  ( 88 )
149 Regulation of mTORC1 on amino acid sensing and its role in the development of cancer
YANG Jian, XU Hong-xia
Cell growth is regulated precisely by many nutritional and growth factors. Protein is the most abundant macromolecular substance in the cell. Amino acid, as its metabolic substrate, is involved in many important physiological processes including protein synthesis. Moreover, amino acid, as a vital signaling molecule, is also important in the regulation of many pathophysiological changes. In recent years, studies have paid more attention to nutritional sensing and its pathophysiological significance. As the vital role in the cell growth, amino acid sensing has received the most attention. mTORC1 is the key sensing signaling in amino acid sensing. The precise sensing of amino acid in the cell is important to the normal functions of mTORC1. Many amino acid sensors, including amino acid transporters, taste receptors and GCN, mediate amino acid signaling, regulate the mTORC1 activity, and are associated with the process of amino acid sensing. More importantly, the dysregulation of mTORC1 on the amino acid sensing play an important role in the proliferation and metastasis of malignant tumor. More and more studies show that the amino acid sensor and its mediated mTORC1 regulation may be a potential target in the treatment of cancer. In this article, we review the functions of mTORC1 in the regulation of amino acid sensing and its role in the development of malignant tumor.
2017 Vol. 4 (2): 149-153 [Abstract] ( 217 ) HTML PDF (2555 KB)  ( 112 )
155 Traditional Chinese herbal extract in tumor immunonutrition
1CHEN Hai-tao, 1XU Chao, 2, 3YAO Qing-hua
Malignant tumor has become a common disease. In recent years, the incidence and mortality of tumors have gradually increased in China, which has become an important obstacle to the development of national economy. Traditional Chinese medicine as an important part of tumor internal medicine treatments has played an irreplaceable role. Traditional Chinese medicine can reduce side effect, increase curative effect and greatly improve the patients' prognosis and the quality of life after treating with surgical treatment, radiochemotherapy and biotherapy, which has become the necessary part of tumor therapy. With the development of modern drug extraction technology and molecular biology technology, Chinese herbal extract comes from natural plants has gradually been paid great attention in clinical because of their advantages of efficacy safety and convenience to use, which has become a kind of important antitumor drugs and tumor adjuvant therapy. A large number of studies have shown that traditional Chinese herbal extract not only has obvious anti-tumor effect, but also can improve the tumor immune microenvironment, enhance tumor immune surveillance, protect intestinal mucosal barrier, regulate tumor nutrition metabolism and promote tumor cell apoptosis, and so on. Therefore, in this article we will analyze the concrete mechanism of the treatment action of Chinese medicine extract in tumor immune from the relationship between traditional Chinese herbal extract and immune organs, inflammatory cytokines, cell defense function, antioxidant and direct anti-tumor effect.
2017 Vol. 4 (2): 155-160 [Abstract] ( 311 ) HTML PDF (1490 KB)  ( 130 )
161 Attention to nutritional support in patients receiving radiation therapy
1,2LIU Jie, 2YU Jin-ming, 2YUAN Shuang-hu
Malnutrition was prevalent in cancer patients with incidence ranging from 40% to 80%. About 97% of the patients needed nutritional therapy. Malnutrition in oncology patients might be caused by multiple factors, including the psychological changes of tumor, response to the tumor and cancer treatment. About 70% of tumor patients prescribed radiotherapy in the course of therapy. However several acute and chronic responses accompany during and after the radiotherapy, which might easily lead to malnutrition in patients and cause therapy interruption and delay. This could have an impact on the quality of the patients’ lives and the therapeutic effect, having adverse effects on prognosis. Nutritional therapy could help radiotherapy patients pass through adverse reaction stage, reduce the toxic reaction caused by radiotherapy, improve phycical condition and reduce the occurrence of adverse events. Therefore, we should reinforce the nutritional status assessment during and after the radiotherapy scientifically and comprehensively and give individual nutritional therapy as early as possible. These might improve the nutritional status and quality of life of patients, which could not only help anticancer therapy, but also reduce the risks of tumor progression and improve the outcomes. This article summarized the malnutrition problems resulting from radiotherapy to the body and the influence of nutritional therapy on radiotherapy effect and physical condition of patients. The article suggested nutritional therapy plays an important role in improving quality of life and prognosis of patients by reviewing the application of nutritional therapy in patients with radiotherapy.
2017 Vol. 4 (2): 161-165 [Abstract] ( 157 ) HTML PDF (1152 KB)  ( 80 )
166 Percutaneous endoscopic gastrostomy/ jejunostomy
Chinese Anti-Cancer Association, Chinese Society for Oncological Nutrition and Supportive Care, The Committee of Rehabilitation
PEG was developed rapidly in recent years, attracted the attention of the clinicians. ESPEN regarded PEG as the preferred way of radiotherapy in patients with enteral nutrition, and it was recommend in the 2006 tumor enteral nutrition guidelines. Clinical practice had proved that advanced head and neck cancer patients could get nutritional treatment through PEG, stoping and reversing weight loss. PEJ was developed based on the PEG, PEJ was more suitable for patients with gastric/esophageal reflux, incomplete pyloric/duodenal obstruction and delayed gastric emptying. There was not high level of RCT comparing PEG with PEJ until now. The usage of PEJ was similar as PEG, the choice of PEJ should considered whether the patients was contraindicated for PEG.
2017 Vol. 4 (2): 166-167 [Abstract] ( 224 ) HTML PDF (987 KB)  ( 75 )
168 A prospective study on the effect of nutritional intervention on nutritional status in head and neck cancer during #br# chemoradiotherapy
LI Chu-rong, LI Tao, LI Fang, WANG Jun-chao, LV Jia-hua, LIANG Long
Objective To investigate the effects of nutritional therapy on nutritional status during the therapy of head and neck cancer patients, which were treated with platinum medication and chemoradiotherapy. Methods A total of 96 cases of head and neck cancer patients were randomly divided into a study group (n=48) and a control group (n=48). They were given nutritional intervention and conventional diet respectively during radiotherapy and chemotherapy. The nutritional status of the two groups were observed. The primary end point of this study was body weight changes, and the secondary indicators of this study included white blood cells, lymphocyte, albumin and other nutritional indicators. The statistics were analyzed by using SPSS software package. Results Both groups of patients showed different degrees of weight loss, bone marrow suppression and decreasing nutritional indicators during the treatment. The study group’s body weight loss (P=0.001), the reduction of white blood cells (P=0.009), lymphocytes (P=0.000), hemoglobin (P=0.033) and hypoproteinemia (P=0.010), the chances and severity of low calcium (P=0.020) and magnesium (P=0.006) were lower than the control group’s, these are with statistical differences. Moreover, in the study group, the proportion of the increase of the acute phase reactive protein was significantly lower than that of the control group (P=0.000). Conclusions Nutritional intervention can reduce the incidence of malnutrition in head and neck cancer during radiotherapy and chemotherapy. However whether it will lead to long-term survival benefits, further studies are needed.
2017 Vol. 4 (2): 168-173 [Abstract] ( 265 ) HTML PDF (967 KB)  ( 119 )
174 The relationship between nutritional status and clinical outcome in patients with common malignant tumor
XU Guang-qi, LUO Zhi-peng, SHI Hua-wei, XUE Yao-chun, JIANG Hai-ping
Objective To investigated the common cancer patients' nutritional status, and to discuss the effect of malnutrition on the clinical outcome of patients. Methods 176 new admitted patients with malignant tumor were selected from March 2013 to April 2016. Patients' nutritional status was assessed by PG-SGA within 48 hours of admission, in the same time, the occurrence of infectious complications during the hospital, the hospital stay, the hospitalization expenses, non-planed 30 days re-admission and the death time or the survival time of the patients were recorded. Results In 176 patients, malnutrition incidence was 71.60%; The incidence of infectious complications in patients with malnutrition was 42.06%, which were higher than that in the patients with well nourished (6.00%). The malnutrition group had higher hospitalization expenses and longer hospital stay than the well nutrition group. The rate of non-planed 30 days re-admission in the patients with well-nourished (0) was significantly lower than those with malnutrition (9.52%). The poorer the nutritional status was, the shorter the survival time was. Conclusions The overall rate of malnutrition in common tumor patients were high. The malnutrition will directly affect the patient's clinical outcome, resulting in the higher incidence rate of infectious complications during the hospital, the longer hospital stay, the higher hospitalization expenses, incidence of the higher non-planed 30 days re-admission and the shorter survival time. Malnutrition is one of the independent risk factors that affect the planned 30-day hospitalization and survival.
2017 Vol. 4 (2): 174-178 [Abstract] ( 400 ) HTML PDF (1016 KB)  ( 210 )
179 Immune enteral nutrition on elderly advanced lung cancer patients with chemoherapy
LIU Su-yao, WANG Jun, FAN Wei-fei, MAO Yuan, Wang Lin, XU Ju-qing
Objective To Investigate the effect of immune nutrition on elderly advanced NSCLC patients with chemoherapy. Methods 91 cases of elderly advanced NSCLC patients were selected from our hospital. They were divided into three groups, the first group was immune-enhanced enteral nutrition intervention group (29 patients with normal diets supplemented with immune enhanced enteral nutrition 1,000ml/d), the second group was conventional enteral nutrition intervention group (32 patients supplemented with conventional enteral nutrition 1,000ml/d), the third group was control group (30 patients supplemented with normal diet). We recorded indicators of patients 1 day before chemotherapy and 1 month, 2 months, 3 months after treatment separately including weight, BMI, AC, ALB, HB and PG-SGA score. Then, we compared the differences of adverse reactions among these three groups, such as pulmonary infection, fatigue, nausea, vomiting, diarrhea and constipation. Results All the 91 cases patients completed at least 3 cycles of chemotherapy. Nutritional indicators such as AC, ALB, HB were decreased after chemotherapy in all patients, but PG-SGA scores raised, with significant difference. In group III, nutritional indicators deteriorated significantly higher than other two groups. However, in group I, the decrease of AC, HB and the increase of PG-SGA were less than group II, with statistical differences. Conclusions Chemotherapy could make elderly advanced NSCLC patients worsening in nutritional status. Compared with conventional dietary, supplemented enteral nutrition could serve to maintain body weight and slow down the deterioration of the nutritional status. In addition, compared with standard enteral nutrition, immune enhanced enteral nutrition can better improve AC and PG-SGA score, while reducing the probability of pulmonary infections during chemotherapy, therefore, we believed that the immune-enhancing enteral nutrition is better.
2017 Vol. 4 (2): 179-184 [Abstract] ( 278 ) HTML PDF (1021 KB)  ( 146 )
185 Expression and clinical significance of miR-106a in endometrial carcinoma
1QI Li-ning, 1GUO Yan-pu, 2ZHANG Xia, 2LI Xue-hui, 2ZHANG Hong-zhen
Objective To detect the expression of miR-106a in endometrial carcinoma, atypical hyperplasia and normal endometrium tissues. And to investigate the relationship between the expression of miR-106a and the origination, development, invasion and metastasis of endometrial carcinoma. Methods The endometrium tissue samples from forty patients with endometrial carcinoma, twenty patients with atypical hyperplasia and thirty patients with normal endometrium (from female with abnormal uterine bleeding and myoma uteri) were collected, poly (A)-RT-qPCR was employed to test the expression of miR-106a in different endometrial tissues. The statistical analyses were performed between the expression of miR-106a, miR-10a and the clinicopathological characteristics of endometrial carcinoma. Results The relative expression of miR-106a in endometrial carcinoma, atypical hyperplasia and normal endometrium tissues were 0.667 (0.197, 1.624), 0.245 (0.064, 0.759) and 0.104 (0.003, 1.350) respectively, the expression gradually declined, and the difference was statistically significant (P<0.01). The expression of miR106a in endometrial carcinoma tissues was higher than that in normal endometrium tissues (P<0.01), and atypical hyperplasia tissues (P<0.05), but the difference between normal endometrium and atypical hyperplasia tissues was no statistical significance (P>0.05); The expression of miR-106a in stage III+IV of endometrial carcinoma patients was higher than stage I+II, in patients with lymph node metastasis were higher than that without lymph node metastasis, the difference was statistically significant (P<0.01); The expression of miR-106a in different ages pathological types, pathological grades, myometrial invasion and whether ER-positive, PR-positive of endometrial carcinoma patients had no statistical difference (P>0.05). Conclusions The expression of miR-106a was up-regulated in endometrial carcinoma tissues, it may regulate the origination and development of endometrial carcinoma as an oncogene.
2017 Vol. 4 (2): 185-188 [Abstract] ( 304 ) HTML PDF (1000 KB)  ( 66 )
189 Application of PG-SGA in patients with common gastrointestinal tumors
Objective To evaluate the use of the patient-generated subjective global assessment (PG-SGA) for the assessment of nutritional status in patients with gastrointestinal tumors. Methods 304 patients hospitalized in Huizhou Municipal Central Hospital from May 2015 to May 2016 were enrolled. The diagnosis with gastrointestinal tumors was confirmed by pathological examination and patients received chemotherapy/radiotherapy or surgery or treatment for complication. The patients were interviewed by a trained surgeon using PG-SGA within 24 hours after admission. PG-SGA score ≥ 4 indicated malnutrition. PG-SGA score ≥ 9 indicated serious malnutrition. Results 304 patients participated in this study, 80.6% of the patients’ had PG-SGA score ≥ 4, 34.2% of the patients’ had PG-SGA score ≥ 9. The incidence of malnutrition in the patients received surgery is higher than patients received chemotherapy/radiotherapy, the incidence of malnutrition in the patients with upper gastrointestinal cancer is higher than the patients with lower gastrointestinal cancer, the incidence of malnutrition in the patients of bearing cancer is higher than patients of unbearing cancer. The difference are significant. The correlation between the scores of PG-SGA and the TNM pathological stage is positive; the later stage, the more scores of PG-SGA assessment. The length of hospital stay and the hospitalization costs between patients with and without malnutrition are significant different. Conclusions The incidence of malnutrition in the patients of gastrointestinal tumors is high, we should pay attention to the nutrition assessment and nutrition therapy for these patients. PG-SGA is an appreciated tool for nutritional assessment for patients with gastrointestinal tumors. It can predict the clinical stage, the length of hospital stay and the hospitalization costs. Remove the tumor from the patient is an effect way to improve the nutritional status of the patients with gastrointestinal tumors.
2017 Vol. 4 (2): 189-193 [Abstract] ( 415 ) HTML PDF (988 KB)  ( 126 )
194 Nasal duodenal nutrition tube in postoperative enteral nutrition of esophageal carcinoma
GUAN Zhi-yu, ZHANG Jun, WANG Shuo, MA Zhen-jian
Objective Esophageal cancer was one of the common human gastrointestinal malignant tumor, the postoperative enteral nutrition therapy approach mainly included nasal duodenal nutrition tube and jejunum nutrient catheter. This study aimed to explore the application value of the nasal duodenal nutrition tube in postoperative enteral nutrition of esophageal carcinoma. Methods We enrolled 50 patients, diagnosed as esophageal carcinoma, who received the resection of esophageal carcinoma and postoperative enteral nutrition from Jan. 2014 to Oct. 2016. All the patients were divided into group A and group B, the basic information of two groups of patients such as age, gender were analyzed, and there were no significant differences (P>0.05), the patients of group A were placed the nasal duodenal nutrition tube during operation, the position of the nasal duodenal nutrition tubes were verified by X-ray routinely after operation; group B were placed the jejunum nutrient catheter. All the patients were supported by the enteral nutrition 24 hours after operation. Results All the patients of group A were successfully placed the duodenal nutrition tube, the mean time was 15 minutes. The position of tubes were verified well done in the duodenum by X-ray. The patients of group B were successfully completed jejunostomy, the mean time was 20 minutes, there were no significant differences between the two groups on the tolerance of nutrition tube and incidence of catheter related complications (P>0.05). Conclusions Each of the two approach have advantages and disadvantages, but nasal duodenal nutrition tube was security, economic and feasible for the esophageal carcinoma patients who needed postoperative enteral nutrition, especially it had a wider feasible crowd and could be widely generalized.
2017 Vol. 4 (2): 194-197 [Abstract] ( 248 ) HTML PDF (940 KB)  ( 128 )
198 Improvement of nutritional knowledge attitude practice level of nurses through cancer nutrition therapy training
1ZHANG Xiao-wei, 1CHENG Xue-jiao, 1LI Yao, 2TIAN Yi-qing, 3KANG Lin, 4SHI Han-ping
Objective To investigate the effect of CNT training on the nutritional K-A-P level of nursing staff. Methods Training the nursing staffs with knowledge of CNT and investigate the nutritional K-A-P level. Paired t test was used to test the differences before and after training. Two independent samples t test was used to compare the differences between groups. The single factor variance F test was used to compare the differences among multiple groups. Results After the training, the total score of K-A-P level, the knowledge score (K), the attitude score (A), the practice score (P) were all higher than the sores before training (K-A-P total score: 145.53 ± 24.10 vs. 207.02 ± 24.95, t = -12.793, P<0.001; K score: 16.38 ± 9.19 vs. 61.06 ± 12.38, t=-20.806, P<0.001; A score: 77.34 ± 11.56 vs. 86.17 ± 9.62, t = -4.290, P<0.001; P score: 51.81 ± 14.16 vs. 59.79 ± 17.41, t=2.317, P<0.05). Compared the difference of K-A-P level before and after training among subgroups in different working years, there were significant differences in the total score of K-A-P level, K score and P score. The nursing staffs who worked from 5 to 10 years had the best response. The nursing staffs who worked more than 15 years had the second response. The staffs who worked 10 to 15 years had the worst response (F=9.407, P<0.001; F=7.455, P<0.05; F=3.664, P<0.05). But there was no difference of A score among working year groups (P>0.05). Compared the difference of K-A-P level before and after training among different level of hospital, there were significant difference in the total score of K-A-P level and K score (t=-4.555, P<0.001; Difference of K score: t=-3.780, P<0.001). The improvement for nursing staffs from Non-3A hospital was better than the staffs from 3A hospital. There were no differences in A score and P score (P>0.05). Conclusions The CNT training could effectively improve the level of nutritional knowledge, attitude and practice for nurses. It was worth to be popularized and applied to more nursing staffs.
2017 Vol. 4 (2): 198-203 [Abstract] ( 286 ) HTML PDF (1007 KB)  ( 110 )
204 Enteral immunonutrition in elderly patients with total gastrectomy improves nutritional status and immunoloregulation
WEI Wei, WEN Xu, LI Gang, GU Rong-min, MING Xue-zhi, CHEN Huan-qiu, ZHOU Bin
Objective To investigate the effects of enteral immunonutrition on recovery, nutritional status, immune function in elderly gastric cancer patients after total gastrectomy. Methods 68 cases of elderly gastric cancer patients postgastrectomy were randomly divided into total PN group, EN+PN group. PN group stopped PN after taking semifluid diet. EN+PN group were tube feeding 250ml saline at the first day, 400ml PN at the second day and stopped PN after increasing to 800~1200ml at the 4th day. The recovery, serum marker on nutritional status and immune function were evaluated and compared before operation and on the 1st, 7th day after operation. Results The levels of serum total protein, albumin, prealbumin were significantly decreased in 2 groups on the 1st day after operation (P<0.05), and they were significantly increasedin EN+PN group on the 7th days after operation (P<0.05). The levels of serum IgG, IgM, the helper cells (CD8+, CD4+) and ratio of CD4+, CD8+, (CD4+/CD8+) were significantly decreased in 2 groups on the 1st day (P<0.05) after operation, and IgG, IgM, CD8+, CD4+and CD4+/CD8+ were significantly increased in EN+PN group (P<0.05) on the 7th day after operation. There were no significant difference in postoperative complication between 2 groups (P>0.05). Conclusions Postoperative early usage of enteral immunonutrition can improve the nutritional status and enhance immunity in elderly gastric cancer patients.
2017 Vol. 4 (2): 204-207 [Abstract] ( 253 ) HTML PDF (987 KB)  ( 138 )
208 Lung cancer cell (A549 cell) membrane phospholipid variation before and after radiotherapy
1WU Wen-an, 2LI Chu-rong, 1FENG Po-ru, 1ZHAO Jin
Objective To investigate the changes of A549 cell membrane phospholipids in lung cancer A549 cells before and after radiotherapy, and the relationship between cell membrane phospholipid metabolism and signal transduction pathway and the response of lung cancer cells to radiotherapy. Methods HPLC was used to detect the content of phospholipids in the lung cancer cells before and after 5Gy irradiation in 24 hours after A549 irradiation, to compare and analyse the content of phospholipids, in order to study the relationship between the change of the content and the effect of radiotherapy. Results The analytic result of HPLC showed the content of membrane phospholipid PI, PE and PC decreased in the A549 cell membrane after radiotherapy, with statistics significant deviation (P<0.01), PI: 1.53±0.07, 1.09±0.20, PE: 51.69±4.32, 32.47±6.60, PC: 128.79±7.40, 82.70±3.02, the content of membrane phospholipid PS is more in after radiotherapy than in before radiotherapy, but did not have statistics significant deviation. Conclusions The content of lipids decreased in lung cancer cell in radiotherapy. It is speculated that it is related to tumor cells, apoptosis and necrosis. Therefore, the study on the changes of lipids is of great significance in the treatment of lung cancer with stereotactic radiotherapy (SBRT).
2017 Vol. 4 (2): 208-211 [Abstract] ( 297 ) HTML PDF (1072 KB)  ( 111 )
216 Anti-tumor mechanism of ketogenic diet
1ZHANG Jie, 2YUAN Bao-hui, 1YU Wei-nan, 3MIAO Ming-yong
KD was firstly applied to treat cerebral diseases, such as cerebral glioma, epilepsy and so on. Researches of last two decades found that chronic inflammation, elevated blood glucose were closely related to tumor development. Regular exercise and fasting could lower blood glucose, increase the concentration of plasma ketone bodies and reduce the inflammatory response. KD, characterized as high fat and very low carbohydrate could evoke a physiological state similar to exercise or fasting. These promote its possible use in treatment of metabolic diseases. With the intensive studies of metabolism and nutrition of cancer, there were growing evidences indicating cellular metabolism plays a very important role in the occurrence and development of tumor. With the application of various experimental methods and the breakthrough of signaling pathways, researchers believed altered metabolism of cancer cells is a potential target for therapeutic intervention. Thus, the anti-tumor effect of KD had become a research focus in recent years. Cancer cells depend on glucose as main energy, and the patients themselves need to consume more fat and protein, accordingly, the ketogenic theory providing enough protein and fat, limiting glucose can treat cancer theoretically. The KD making use of the characteristics of mitochondrial defects and glucose dependent of tumor cells, through suppressing inflammation, enhancing immune response, improving the ability of antioxidant stress, regulating related signal pathway, etc., inhibits tumor growth, improves patients’ quality of life, prolonges the survival of patients and enhances the sensitivity to radiotherapy and chemotherapy. These mechanisms provided a theoretical basis for the application of KD in cancer treatment. However, some mechanisms were not fully elucidated, further basic research and clinical trials is needed to confirm.
2017 Vol. 4 (2): 216-220 [Abstract] ( 314 ) HTML PDF (1102 KB)  ( 372 )
221 Research advance in diagnosis and clinical application of preoperative malnutrition in patients with gastric cancer
SHI Bo, LIU Jin-lu, CHEN Jun-qiang
This paper was to investigate the causes of preoperative malnutrition, diagnosis and the relationship between malnutrition and prognosis of gastric cancer, in order to provide guide for clinicians for the diagnosis of malnutrition and improve clinical outcome in patients with gastric cancer. Key words such as “gastric cancer” and “malnutrition” were reviewed in CNKI and Pubmed databases. The definition and diagnosis of preoperative malnutrition in patients with gastric cancer, the causes of preoperative malnutrition in patients with gastric cancer, the relationship between malnutrition and the prognosis of patients, and the value in the clinical application of enhanced recovery after surgery were summarized. The results suggested that, firstly, patients with gastric cancer could be diagnosed by nutritional screening, nutritional assessment, and comprehensive measurement aimed to carry out nutritional therapy. Secondly, the reduction of energy intake, absorption and utilization, the increase of inflammatory and stress levels and metabolic disorders were the main causes of preoperative malnutrition in patients with gastric cancer, and malnutrition was the prognostic factor of patients. It was great significance to improve the clinical prognosis by combining nutritional screening with nutritional assessment to diagnose malnutrition and evaluate the degree for the sake of nutritional therapy effectively and promptly which could not only reduce the incidence of postoperative complications and hospitalization costs, but also shorten the total length of hospital stay and postoperative hospital stay.
2017 Vol. 4 (2): 221-225 [Abstract] ( 333 ) HTML PDF (1187 KB)  ( 117 )
226 Current research situation analysis of nutritional risk and malnutrition of tumor patients in China
1YING Li-mei, 1CHEN Fang-fang, 1CHEN Yi-dan, 1MO Li-qin, 1ZHU Gui-ting, 1LI Yong-qiang, 1CHENG Yu-ming, 1DING Fei, 1DUAN Guang-liang, 2CHEN Bi, 2GONG Lin-yan, 3SHI Hai-bin, 1WANG Kai-feng
The study of nutritional risk and malnutrition of tumor patients increased year by year, which has drawn more and more attention both at home and abroad. Clinical trials showed that cancer patients usually suffered from nutritional risk and malnutrition in China, and the incidence could be 40%~80%, incidence of malnutrition and nutritional risk is higher in patients with advanced malignant tumor. Nutritional risk and malnutrition produces seriously influenced tumor patients’ prognosis, reduced the tolerance and sensitivity of surgery, radiotherapy and chemotherapy, lowered the quality of life and overall survival time. Effective nutritional therapy shortened the length of hospital stay, lowered incidence of complications and hospitalization costs upgraded the quality of life, decreased morality and increased survival time. Tumors in patients with clinical nutrition therapy had become increasingly important, active and effective intervention in patients with malignant tumors is of great significance. This article concluded the research about the progression of nutrition research, reviewed the status of clinical nutrition research of tumor patients and indicated a new idea about tumor treatment and nutritional research. In occurence and development of tumor, using appropriate nutritional screening tools such as nutritional risk screening and subjective global assessment for patients with comprehensive nutritional screening and evaluation as soon as possible, reasonable and effective nutritional therapy has positive clinical value to patients, which will upgrade the quality of life and improve the prognosis.
2017 Vol. 4 (2): 226-231 [Abstract] ( 344 ) HTML PDF (994 KB)  ( 199 )
232 Affecting the compliance of oral nutritional supplements
1HE Ping, 1XU Ke-min, 1LIU Jiang-nan, 2SHI Han-ping
ONS has been proved to improve nutrients absorption and malnutrition while the compliance remains poor. This review explored the contributory factors of the palatability and the compliance of ONS among patients with malnutrition. MEDLINE, Sci Search、AGRICOLA、BIOSIS Previews, CAB ABSTRACTS, Embase, Foodline, CNKI were searched with the keywords regarding palatability, sensory, taste, smell, flavor, appetizing, compliance, ONS, enteral nutrition and dietary supplements. Literature review was conducted through the paper selected by inclusion and exclusion criteria. There found three main categories of the contributory factors which were products features, patients’ personal condition and patients’ living environment. These categories were further subdivided into nutrients, flavor, energy density, ONS volume, viscosity, digestion mechanism, age, diseases, intake time, social isolation, and incentives. It was found that small dose and high energy density ONS was effective to improve the nutrients absorption. As the nutrition status of patients had become more concerned by medical practitioners, malnutrition needed to be diagnosed as early as possible by nutrient screening. Based on the contributory factors on ONS compliance, defining nutrient demanded among patients with different diseases, designing specific nutritional prescription, increasing personal nutrition intake are key ways to benefit malnourished population.
2017 Vol. 4 (2): 232-241 [Abstract] ( 334 ) HTML PDF  (0 KB)  ( 64 )
242 Ferritin provided a new perspective for tumor diagnosis and treatment
CHENG Shi-jia, WANG Xu, LI Wei, CUI Jiu-wei
Iron, as necessary trace element in the human body, was associated with tumorigenesis and development. The free radicals coming from the process of oxidation and reduction cycle of iron, caused harmful effects, such as tumorigenesis. Besides, abnormal iron metabolism increased the risk of tumorigenesis and promotes tumor growth. Ferritin, a glycoprotein synthesized by the liver, played an important role in the balance of iron metabolism. Combined with the free iron, ferritin prevented from toxic effects of high intracellular concentration of free iron. Serum ferritin was a main indicator of iron storage in the body, and the expression levels of ferritin are increased in majority patients with cancer. Furthermore, ferritin was also involved in tumorigenesis and development by anti-oxidative damage, angiogenesis, immunosuppression and promoting cell proliferation. The survival of patients with high expression of ferritin was worse, suggesting that it could be used as prognostic indicator of cancer patients. On the other hand, the down-regulated expression of ferritin could not only inhibit the proliferation of cancer cells, but also increased their sensitivity to chemotherapy. It was implicated that ferritin may have potential in treatment of cancer. Although many new findings have led to a further understanding of ferritin, further research is needed to shed new light on the role of ferritin. In this review, we aim to provide an overview about the clinical significance of ferritin and its further application in the treatment of cancer, based on the recent advances in tumorigenesis mechanism of ferritin, and the studies of correlation between its expression and prognosis.
2017 Vol. 4 (2): 242-246 [Abstract] ( 234 ) HTML PDF  (0 KB)  ( 60 )
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