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2017 Vol. 4, No. 3
Published: 2017-09-09
 
247 The occurrence and development of cachexia and muscle microenvironment
1XU Wen-wen, 2WANG Shu-an, 3ZOU Zheng-yun
Cachexia is one of the most common complications of cancer. The prominent clinical feature of cachexia is muscle wasting. And protein degradation in skeletal muscle is important in the pathophysiology of cachexia. Cachexia can caused by abnormal metabolism of skeletal muscle in cancer patients resulting from increased energy expenditure and invalid energy utilization. Also, the muscle microenvironment is closely associated with the development of cachexia, many biological factors could directly or indirectly lead to proteolysis and skeletal muscle atrophy. It is estimated that cachexia occurs in half of cancer patients, and is responsible for the death of 20%~40% of malignant cancer patients. Cachexia is distinct from starvation, stress-related loss of muscle mass and has severe consequences. Current interventions cannot reverse its process; therefore, it is important to measure body composition, observe the dynamic changes of skeletal muscle and implement nutritional intervention as early as possible.
2017 Vol. 4 (3): 247- [Abstract] ( 361 ) HTML PDF (1424 KB)  ( 183 )
253 Holistic care in cachexia therapy
PENG Rui, GUO Qiao-yun, SONG Chun-hua
Cachexia is a state of wasting metabolism, which mainly occurs in cancers and other major chronic diseases and could seriously reduce the survival rate and the quality of life. Though it gained many researches on cachexia recent years, to date, the mechanism has not yet been elucidated and there is no effective means to cure cachexia. "Holistic care" not only care for body, mind and spirit, but also for the whole course from begin of disease to death; not only take care of patients, but also includes family members; not only treat patients by doctors, nurses, but also psychologists, nutritionists and other careermen participate in the professional care team. The terminal character of cachexia is irreversible, thus “holistic care” needs to be applied to the treatment in order to improve the quality of life of cachexia patients. "Holistic care" can effectively relieve the physical pain and mental pressure from patients and family members. Moreover, it also has far-reaching social significance and is conducive to social harmony and stability. But, at the same time, the development degree of “holistic care” in China is limited and in the backward position in the world. Therefore, some problems such as the choice of life to self-decision, the limited social acceptance and policy support need we face and solve actively. Our paper reviews the role of “holistic care” in treating cachexia and provides theoretical basis of the development and application of “holistic care” in China.
2017 Vol. 4 (3): 253- [Abstract] ( 335 ) HTML PDF (1011 KB)  ( 129 )
258 The anti-tumor effect of vitamin D and esophageal cancer
ZHAO Qin, YANG Zhi-yong, ZHUANG Ze-hao
Vitamin D is a fat soluble vitamin essential to human body. Many of the biological functions of vitamin D are mediated by vitamin D receptor (VDR), which regulates the transcription of target genes. It has been found that vitamin D deficiency is associated with the development of a variety of tumors, while vitamin D supplement may reduce the incidence of a variety of tumors, and improve the survival rate and prognosis of some tumors. It has been documented that vitmin D and its analogues can not only regulate calcium and phosphorus metabolism, but also play an anticancer role by inhibiting tumor cell proliferation, inducing tumor cell differentiation or apoptosis, anti-angiogenesis, inhibiting malignant cell transfer and inhibiting inflammation. However, the association between the prevalence of esophageal cancer (EC) and vitamin D levels remains controversial. The significant differences in the risk of vitamin D and EC in different studies may be related to the gender, age, and the histological characteristics of EC. In vitro and animal model studies showed that vitamin D could inhibit the proliferation of EC cells. It has also been found that EC patients with high expression of VDR have a good prognosis, VDR gene polymorphism may be associated with EC. This review present the current opinions on the structure, function, anti-tumor mechanism of vitamin D and its receptor, and its roles in the carcinogenesis of esophageal cancer.
2017 Vol. 4 (3): 258- [Abstract] ( 372 ) HTML PDF (1853 KB)  ( 154 )
263 Ketogenic diet and fat loss
JIANG Bo
Ketogenic diet was used in children to remedy epilepsy nearly 100 years. Such long history fully proved its safety and effectiveness. In the field of weight management, ketogenic diet had strong practicality, easy operation and long persistence. Due to the high fat diet in ketogenic diet existed cognitive bias with traditional nutrition knowledge, either theory or the of clinical practice needed standardized training. This paper introdused the background, biochemistry, indications, contraindications, adverse reactions of the ketogenic diet, as preliminary exposition and base, ready for co-authoring specialist consensus with other experts. Diet, exercise, or operation are frequency-used methods in loss weight by limiting energy intake or increasing energy consumption, while ketogenic diet was another mechanism differing these methods. Ketogenic diet simulated starvation by controlling carbohydrate intake, transforming triglyceride into ketone, then excreting ketone from the urine. Elevatory ketone also can suppress appetite to reduce food and energy intake. The indications of ketogenic diet were: BMI>28; with normal liver and kidney functions. Contraindications were patients whose lack functional key enzyme for fat metabolism, and failure of liver and kidney functions. Baseline assessment is necessary before initiating ketogenic diet, Blood and urine ketone should to be monitored during whole ketogenic diets loss procession.
2017 Vol. 4 (3): 263- [Abstract] ( 334 ) HTML PDF (1221 KB)  ( 429 )
267  Adipose tissue and cachexia: white or brown
DONG Ya-bing, WANG Nan-ya
The adipose tissue of the human body can be divided into two types-- white adipose tissue and brown adipose tissue. The white adipose tissue is mainly responsible for energy storage, and the while brown adipose tissue plays a main role in consuming energy and heat production. Recent studies have shown that there exists a third type of adipose tissue in white adipose tissue namely brown adipose tissue, which is converted from the white adipose tissue and is similar to brown fat cells in the function, the process called "white fat browning". White adipose browning is one of the important characteristics of cancer cachexia adipose metabolism. On the one hand, the white adipose tissue affects metabolism through increasing the amount of heat consumption after browning, and then results in a decrease in fat; On the other hand, browning will also affect the happening of cancer cachexia itself. The two major driving factors--interleukin-6 and parathyroid hormone related protein secreted by tumor tissue mainly via exciting sympathetic nervous system to release norepinephrine, which acts on β3 adrenal hormone receptor of adipose cells and then activate transcription factors and the corresponding heat producing gene expression such as UCP1, cause browning. It is not only an early event in the development of cancer cachexia, but throughout the entire process of cachexia. By means of the early detection and intervening all links of the browning process, we can improve clinical outcomes and provide the basis for the early diagnosis, prevention and treatment of cancer cachexia.
2017 Vol. 4 (3): 267- [Abstract] ( 326 ) HTML PDF (2666 KB)  ( 174 )
272 The enteral nutrition in radiotherapeutic cancer patients
All the cancer patients receiving radiotherapy should routinely undergo three-stage diagnosis of malnutrition after cancer diagnosis or admission to the hospital. The three-stage diagnosis of malnutrition includes nutritional screening, nutritional assessment and comprehensive measurement. NRS-2002 is recommended for nutritional risk screening, and PG-SGA is recommended for nutritional assessment. Conventional nutritional therapy is not recommended for cancer patients. We should correctly assess the nutritional status of patients using PG-SGA and acute radiation injury during radiotherapy according to RTOG criteria. According to the results of the comprehensive evaluation, patients who are malnutrition or at risk of malnutrition will receive nutrition therapy in time on the basis of the treatment path. The five-step nutrition treatment principle is also adopted for the radiotherapy cancer patients, and the four-step principle is adopted for the choosing of enteral nutrition pathway. Prophylactic implantation of nutrient tube before radiotherapy is not recommended unless the patients has one or more of the following situations: significant weight loss (greater than 5% within one month or greater than 10% within six months), BMI less than 18.5, severe dysphagia or painful swallowing, severe anorexia, dehydration, and prospective severe radiation-induced oral or esophageal mucositis. The recommended amount of energy intake for radiotherapy patients with malignant tumor is 25~30kcal/(kg·d). It should be adjusted dynamically according to tumor burden, stress state and acute radiation injury during radiotherapy. We should reduce the proportion of carbohydrates and increase the proportion of protein and fat supply in the total energy supply. Glutamine is beneficial in reducing the incidence of radioactive skin toxicity and severity of radiation mucositis. Omega-3 PUFA is beneficial for improving immune function and regulating inflammatory response in patients undergoing radiotherapy. It is recommended that glutamine and Omega -3 PUFA be added to the enteral nutrition formula. Doctors should evaluate the efficacy and adverse reactions of enteral nutrition according to the reaction speed of different observation indexes during radiotherapy. Radiotherapy patients with malignancies who are out of hospital should be given home enteral nutritional support and management if they are still suffering from inadequate intake of nutrients through mouth, or who have the nutrient tube dependence.
2017 Vol. 4 (3): 272- [Abstract] ( 487 ) HTML PDF (1094 KB)  ( 496 )
280 The nutritional therapy of active whey protein in pancreatic tumor-bearing nude mice
1ZHANG Jie, 2LIU Xiao, 1YU Wei-nan, 3MIAO Ming-yong, 4SHI Han-ping
Objective Active whey protein preserved the active ingredients in cow milk processed with patented low temperature extraction technology. Protein contents up to 90%. In addition, it has many biological functions such as improving the nutrition status and strengthening immunity. It’s one of the important components in clinical nutritional therapy. This research is to study the effect potential mechanism and potentiof active whey protein on pancreatic carcinoma established in vivo model. Methods Xenotransplanted pancreatic carcinoma was established by panc-1 cell line, then divided into 3 groups, 8 mice of each randomly according to the different way of nutritional intervention: standard diet group (SD group), standard diet with soy group (Soy group), standard diet with active whey protein group (ABD group). During the experiment, animals' body condition was observed, weight of nude mice, tumor size and weight were recorded. And, compared the average survival time of mice. Meanwhile, we detected the glutathione levels in the blood and carcinoma. Results Weight loss of all mice in the three groups was observed. Weight of mice in ABD group (24.35±1.89)g was significantly higher than SD group (20.04±2.41)g 8 weeks after treatment (P<0.05). Volumn and weight of mice transplanted tumor in the three groups was no statistical difference. At the end point, compared with the SD group and Soy group [(56.00±5.29)d and (51.63±10.54)d, respectively], the average survival time of mice in ABD group(62.13 ± 2.47)d was significantly higher (P<0.05). There was no statistical difference between SD group and Soy group (P>0.05). The GSH level in the blood of ABD group was significantly higher than SD group and Soy group (P<0.05) when the level in the tumor of ABD group was lower but there was no statistical difference. Conclusions Active whey protein can prevent the weight loss in transplanted pancreatic mice, prolong the survival time, and this may be associated with preventing and curing cancer cachexia.
2017 Vol. 4 (3): 280- [Abstract] ( 297 ) HTML PDF (2137 KB)  ( 173 )
286 The early enteral nutrition VS delayed enteral nutrition in postoperative esophageal cancer patients#br#
1ZHANG Nan, 1GUO Min, 1WANG Cui, 2WANG Gong-chao
Objective We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. Methods A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (group 1, 2 and 3) based on whether they received EN within 48 h, 48 h~72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney u-test and the chi square test. Statistical significance was defined as P<0.05. Results Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in group 3 (P= 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in group 3. Conclusions It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients
2017 Vol. 4 (3): 286- [Abstract] ( 292 ) HTML PDF (977 KB)  ( 152 )
291 The nutritional therapy and enhanced rehabilitation surgery in perioperative colorectal cancer
1WEI Cheng, 1TENG Wen-hao, 1CHEN Shu, 1HE Hao, 1CHEN Jing-hong, 2LIAO Ling-hong, 1ZANG Wei-dong
Objective To explore the feasibility and advantages of perioperative nutritional therapy and accelerated rehabilitation surgery in the perioperative application of colorectal cancer. Methods A retrospective analysis on 110 cases of cT1~4a N0~2M0 colorectal cancer patients was performed. According to the different perioperative measures, they were divided into two groups, nutrition & ERAS group (62 patients) and traditional treatment group (48 patients). Before operation, the patients in nutrition & ERAS group were screened and scored with preoperative nutritional status, and after treated by nutritional therapy, they werethen underwent laparoscopic radical surgery. During the operation, several measures would be performed including keep warmth during anesthesia, insert analgesic pump and remove the drainage tubes at early stage or even retain none tubes. Moreover, the gastrointestinal decompression tube was removed at early stage or not retain, and early off-bed activity and liquid diet would be encouraged to support treatment. What’s more, we tried our best to give them 5 days intravenous fluids supplement. On the other hand, the patients in traditional treatment group were treated with common perioperative measures. Then the data would be compared between two groups. Results The averaged time of exsufflation, infusion days and postoperative hospital stay in nutrition & ERAS group were (2.2±0.8) days, (5.8±1.2) days and (7.8±1.5) days respectively. And they were shorter than traditional treatment group significantly (P<0.05). Moreover, it showed less morbidity of pulmonary infection and abdominal infection, and less pain score in 5 days after operation (P<0.05). Conclusions The application of perioperative nutrition therapy and accelerated rehabilitation surgery could accelerate the rehabilitation of colorectal cancer.
2017 Vol. 4 (3): 291- [Abstract] ( 323 ) HTML PDF (1044 KB)  ( 148 )
297 The prognostic nutritional index and pathological features of gastric cancer
JIA Jing
Objective To investigate the application of Onodera’s prognostic nutrition index (OPNI) and clinicalpathological features in risk evaluation of prognosis of gastric cancer patients. Methods The clinical data of 46 gastric cancer patients who underwent radical gastrectomy in our hospital during 2012 was analyzed retrospectively. The OPNI value was calculated by serum albiumin (g/L)+5×lymphocyte count (×109/L). The receiver operating characteristic (ROC) curve and Youden index were used to determine the cutoff value of the OPNI. Survival curves were describe by the Kaplan-Meier method and compared by the Log-rank test. The univariate and multivariate analyses were performed with Cox proportional hazard model to identify the prognostic factors. Results The mean values of the OPNI in negative lymph node, pTNM, normal CEA and CA199, no postoperative complication were significantly higher than those in patients without such factors. When the OPNI was 38.175, the Youden index was maximal. Tumor infiltration depth in high OPNI group was less than in low OPNI group. The proportion of lymph node invasion in high OPNI group was significantly lower than in low OPNI group. The overall survival rate in high OPNI group was higher than in low OPNI group. The univariate and multivariate analyses showed that patient age and OPNI were independent factors for predicting overall survival rate. Conclusions The OPNI value is a simple and intuitive tool to predict the prognosis of patients with gastric cancer.
2017 Vol. 4 (3): 297- [Abstract] ( 363 ) HTML PDF (1329 KB)  ( 130 )
303 The inverted nasojejunal tube implantation and jejunostomy in Ivor-Lewis esophagectomy patients
ZHANG Zhi, YUAN Fang-liang, REN Bin-hui, YU Yong, DONG Gao-yue, LI Li, XU Lin
Objective This study aims to comparaethe method and clinical outcomes of the inverted nasojejunal tube placement and jejunostomy on patients undergoing Ivor-Lewis esophagectomy. Methods A total of 268 esophageal carcinoma patients who have undergone Ivor-Lewis esophagectomy between January 2010 and December 2013 participated this study. Feeding tubes were inserted via the inverted nasojejunal tube placement of 58 cases and by jejunostomy in 210 cases. We compared the clinical outcomes of two methods. Results Feeding tubes were successfully inserted in all patients during operation. No death or nutritional and metabolic disorders were documented during the observation period. Inverted nasojejunal tube placement group compared with jejunostomy group, the anus exhause recovery more faster, two groups are significant (P<0.01); though the anus bowel movement recovery time shorter than the jejunostomy group, two groups are unsignificant (P>0.05). An intestinal obstruction was observed in the jejunostomy group. Unplanned extubation occurred in two patients in inverted nasojejunal tube placement group. Conclusions Compared with jejunostomy, the method of inverted nasojejunal tube placement was a non-invasive technique, it was more convenient and practical, and it was easier to master. It was a safe and effective route of nutritional support, and was worthy of clinical application.
2017 Vol. 4 (3): 303- [Abstract] ( 339 ) HTML PDF (1006 KB)  ( 107 )
307 Cyclin D1(CCNDl)A870G gene polymorphism and colon cancer in Baoding region
ZHANG Pei-jun, WANG Qian
To study the relationship between the cyclin D1(CCNDl)A870G gene polymorphism and age, sex, smoking, family history, pathological typing and tumor stage for the patients with colon cancer (in Baoding). Cyclin D1(CCNDl)A870G genotype wasdetermined by polymerase chainreaction (PCR) and restriction fragment length polymorphism analysis (RFLP) of DNA extracted from blood. The study included 200 colon cancer patients and 200 healthy control subjects. Genotype frequencies of patients and controls both conformed to the hardy equilibrium. The GG genotype significantly correlated with a history of heavy smoking and Hypercholesterolemia (P<0.05). We conclude that hypercholesterolemia and smoking may be a risk factor for colon cancer in the GG genotype of cyclin D1(CCNDl)A870G polymorphism, the frequency of AA genotype in patients with hereditary factors was significantly higher than that of other genotypes, (P<0.05). There was no significant difference in GG genotype between severe smokers and hypercholesterolemia patients (P>0.05). It can be concluded that genetic factors can be used as a risk factor for colon cancer in the AA genotype of cyclin D1(CCNDl)A870G polymorphism, which will provide a basis for further study on the molecular mechanism of colon cancer.
2017 Vol. 4 (3): 307- [Abstract] ( 252 ) HTML PDF (1148 KB)  ( 112 )
312 The postoperative recovery of fast track surgery pattern in gastrointestinal cancer patients#br#
DING Yan, WANG Bei, LI Jiu-fan, CHANG Juan-juan
Objective To study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastrointestinal cancer patients during the perioperative period. Methods 260 gastrointestinal cancer patients were randomly divided into two groups, 132 in FTS pattern (FTS group) and 128 in traditional pattern mode (TPM group). Analysis and research on the scores of hospital anxiety and depression scale (HAD) before and after operation, intraoperative temperatures, the incidence of postoperative hypothermia and chills, postoperative pain, patients' satisfaction and wound healing were compared. Results The score of anxiety, depression and HAD, incidence of postoperative hypothermia and chills, postoperative incision infection rate were lower in FTS group. FTS also provided superior pain relief and patients' satisfaction compared with traditional pattern. There was no significantly different between the two groups for the intraoperative temperatures. FTS group of patients with ICU hospitalization time, incidence of pulmonary infection, medical expenses and hospitalization time were lower than those of TPM group, but the complications about the abdomen had no difference between the two groups. Conclusions Perioperative gastrointestinal cancer patients with fast track surgery mode could be significantly reduced the incidence of surgical complications in patients, shorten the hospitalization time and total ICU, saved medical costs and improved the patients' satisfaction.
2017 Vol. 4 (3): 312- [Abstract] ( 323 ) HTML PDF (1002 KB)  ( 126 )
317 NRS 2002, PG-SGA, BMI, TF in nutritional screening and assessment of gastric cancer patients
1HUANG Dao-lai, 1WU Xiang-hua, 1CHEN Jun-qiang, 1XU Yu-ju, 1JIA Kui, 1ZHOU Jing, 1LU Li-sheng, 1ZHU Wen-xiang, 1LI Feng-xi, 2ZHANG Yong-sheng,2JINJing,2HUANG Ke-ke
Objective To understand the application of nutrition risk screening 2002 (NRS 2002), patient-generated subjective global assessment (PG-SGA), body mass index (BMI), serum transferrin (TF) in nutritional screening and assessment of the hospitalized patients with gastric cancer and analyze the correlation between them. Methods 136 patients with gastric cancer hospitalized in our hospital from January 2015 to September 2016 were consecutively enrolled in this study. Nutritional risk screening by NRS 2002 and assessment of nutritional status by PG-SGA were performed in their first 24 hours in hospital. Their BMI, TF were measured at the same time. Results There were 64 patients (47%) of non nutritional risk (NRS 2002<3), while 72 patients (53%) of nutritional risk (NRS 2002≥3). There were 5 patients (4%) of eutrophy (PG-SGA 0~1), 21 patients (15%) of suspected malnutrition (PG-SGA 2~3) and 49 patients (36%) of moderate malnutrition (PG-SGA 4~8) while there were 61 patients (45%) of severe malnutrition (PG-SGA≥9). The age was positively correlated with NRS 2002 and PG-SGA (P<0.01). The TF, BMI, body weight were negatively correlated with NRS 2002 and PG-SGA (P<0.05), and the body height was not correlated with NRS 2002 and PGSGA (P>0.05). There was a significant correlation between NRS 2002 and PG-SGA score (r= 0.565, P<0.01). Conclusions There is high incidence of preoperative malnutrition and nutritional risk in patients with gastric cancer. NRS 2002, PG-SGA and BMI, TF can be beneficial for the overall assessment of nutritional status and the analysis of nutritional risk for patients with gastric cancer. The combination of them may be more helpful in perioperative nutritional treatment in patients with gastric cancer.
2017 Vol. 4 (3): 317- [Abstract] ( 405 ) HTML PDF (1117 KB)  ( 129 )
322 The radio-pulmonary lesion in three-dimensional conformal intensive modulated radiotherapy of esophageal cancer#br#
1MENG Ling-xin, 2HAN Jing, 1ZHOU Dan-dan, 1WANG Chuan-yan, 1LI Bing-cheng, 1MENG Qin, 1WU Hai-ying
Objective To investigate the related factors of radiation-induced lung injury (RILI) in three-dimensional conformal intensity modulated radiation therapy (IMRT) for middle and lower esophageal cancer, and to provide evidence for the selection of radiotherapy for esophageal carcinoma. Methods 72 cases of esophageal cancer patients in our hospital from May 2011 to May 2014 were selected for the radiotherapy. The varian Ix-6074 linear accelerator and Eclipse 11 radiotherapy planning system was applied to produce plan, and the whole prescription dose (60~68) Gy/ (30~34) F, 95% of the planning target volume (PTV) reached the prescribed dose under the premise of using dose volume histogram (DVH) of lung tissue by comparison when the irradiation dose volume and RILI, and to explore the correlation between clinical factors and RILI. Results Follow up study revealed the one-year overall survival rate of 94.44%. In the middle and lower esophageal cancer patients, the length of tumor lesion, the COPD and the total dose of radiotherapy were associated to the incidence of RILI after IMRT. 9 cases of the 72 patients had found radiation-induced lung injury (12.50%). There was significant difference between the patients of RILI and the patients of no radioactive lung injury for the V10, V15, V20, V30 and Dmean (all P<0.05), however, V5, V25, V35, V40, Dmax and Dmin in the patients between the two groups showed no significant difference (all P>0.05). Conclusions V10, V15, V20, V30 and lung Dmean dose of lung are the key factors of RILI. Radiation dosimetry in IMRT for esophageal carcinoma can predict the incidence of radiation-induced lung injury better.
2017 Vol. 4 (3): 322- [Abstract] ( 304 ) HTML PDF (1007 KB)  ( 105 )
327 Anastrozole therapy in postmenopausal breast cancer secondary to osteoporosis
LI Wen-huan, ZHOU Zhuo-hui
Objective To collect postmenopausal breast cancer patients taking anastrozole after the relevant clinical indicators, The predictive model was established to evaluate the predictive value of secondary osteoporosis (OP), and then verify its applicability. Methods Continuity included in the period from May 2013 to April 2014 in Wuhan City Center Hospital treated with anastrozole endocrine therapy for postmenopausal breast cancer patients for the study of the cohort, the clinical data were collected and followed for a follow-up of 36 months to confirm prognosis. According to the follow-up results predictive secondary risk of OP risk indicators, and analyze the secondary OP time window to verify the applicability of the prediction model. Results The final collection of 252 cases of breast cancer patients in line with the clinical trial requirements, of which 12 patients were lost, 75 patients secondary to OP, 165 patients in the follow-up period of bone mineral density normal or relatively normal. Cox regression analysis showed that the independent influencing factors of adjuvant OP in patients with postmenopausal breast cancer were determined by the time of menopause, the time of taking anastrozole, the time of bisphosphonates, the contents of alkaline phosphates (ALP) Among them, menopause time and taking anastrozole time as a risk factor, taking bisphosphonates time and ALP content as protective factors; taking anastrozole time≥3.07 years, taking bisphosphonates time <1. 878 years of patients, secondary OP time window shorter, the critical value of a significant evaluation of efficacy. Conclusion Menopause time, taking anastrozole time, taking bisphosphonates time, ALP content is anastrozole in the treatment of postmenopausal breast cancer secondary OP independent factors, and taking anastrozole time≥3.07 years, taking bisphosphonates time <1.788 years to measure the disease secondary to the patient's time nod
2017 Vol. 4 (3): 327- [Abstract] ( 321 ) HTML PDF (1399 KB)  ( 93 )
333 Ketogenic diet and obesity
YANG Hui, 1ZHU Jiang-li, 1CHEN Qiu-xia, 2JIANG Bo
Objective To investigate the effect of ketogenic fat on body weight, body fat and visceral fat. Methods In this study, we recruited several volunteers whose meet the standard of clinical studies. According to the basic principle of the ketogenic diet, we manage diets of volunteers, measure body weight, skeletal muscle weight, body fat by body composition analysis, calculate waist hip ratio based on anthropometry data at regular intervals. Results From the the first week, body weight of volunteers has begun declined, accumulating weight reduction is （3.99±2.29）kg in 4 weeks, body fat reduction continued decline during ketogenic diet period, shows positively relationship: y=1.32423 0.37536*x, R2=0.81966. At the same time, ketogenic diets also can effectively reduce hip ratio dieters (y=0.016 0.00476*x, R2=0.61009). Conclusions the ketogenic diets has obviously affect on body fat reduction and waist to hip ratio decreased, and has positive correlation to time of duration. Ketogenic diet used in clinical treatment has lasted nearly a hundred years, its indications from epilepsy extended to weight reduction, tumor therapy, and so on.
2017 Vol. 4 (3): 333- [Abstract] ( 405 ) HTML PDF (1805 KB)  ( 487 )
338 Circadian rhythm and cancer
YANG Liu-qing, SHI Han-ping
Circadian rhythm, regulated by clock control genes, is a sort of biological rhythm system which possess selfregulating function and accompany with day and night repeat on a near 24-hour basis. Circadian clock genes can control and regulate sleep, wake up, metabolism, endocrine, immune, cell proliferation and apoptosis in the molecular level, to make vital movement in tissues and cells cooperatively and orderly, as well as present distinct circadian rhythms. Organism lost regulating effect on cell growth in genetic level is the primary cause of cancer. The relationship between circadian rhythms and cancer is taken seriously recently. Epidemiologic studies in humans and animal models have revealed that development of common types of cancer such as breast cancer, ovarian cancer, lung cancer, pancreatic cancer, prostate cancer, colorectal cancer, endometrial cancer, non-hodgkin's lymphoma, osteosarcoma, leukemia, head and neck squamous carcinoma and liver cancer in vivo is closely associated with the loss of circadian homeostasis. Circadian clock genes can directly or indirectly affect oncogenesis, cancer progression, and suppression by regulate expression of tumor suppressor gene and oncogene and transcription factor. Further study on molecular mechanism between circadian rhythm and cancer development and suppression is necessary. To illustrate the relationship between circadian clock genes and cell cycle will help us understand the mechanism of tumorigenesis, transfer and spread, which will improve the clinical outcome, and provide important basis on clinical cancer diagnose, treatment and prognosis.
2017 Vol. 4 (3): 338- [Abstract] ( 321 ) HTML PDF (1511 KB)  ( 244 )
343 Metabolic syndrome and malignant neoplasms
1AN Yun-feng,1LI Xia, 2XIANG Yue-ying, 1ZHANG He-jun, 1XIANG Zhen
Malignant tumor has been a major diseases threat to human health, with current social habits, diet, living environment and other factors changing, the incidence of malignant tumors have also undergone significant changes. The set of diabetes/ hyperglycemia, hyperlipidemia and hypertension, which is obesity, has been a risk factor for many kinds of major diseases. A growing number of studies confirmed that a variety of malignant tumor associated with MetS, MetS and malignant tumor have been a global problem threatened human health. In recent years, the further researche of basic medical sciences and epidemiology on MetS-induced malignant tumor clarified the intimate relationship between MetS and malignancy, each factor of MetS is interrelated, the accumulation of individual factors increased the risk of cancer and mortality. With further research, the molecular mechanisms are gradually discovered, the molecular mechanism which accumulation of risk factors induced tumor is more explicit, possible mechanisms include: the role of long-term hyperglycemia, obesity and hyperlipidemia, the role of insulin factor and secretion factor interferences which coordinate the action, and the prevention and treatment in clinical of tumor is also gradually improved. This review will describe the association between metabolic syndrome and malignant tumor from the points of the epidemiology and molecular mechanism based on recent years related research.
2017 Vol. 4 (3): 343- [Abstract] ( 317 ) HTML PDF (965 KB)  ( 190 )
349 Intestinal flora and thyroid associated diseases#br#
WANG Xiao-wei, XU Yuan-hong
The intestinal flora is composed of a large number of aerobic and anaerobic bacteria, viruses and other components, which involved in maintaining many physiological function of the body. It has a crucial link with the balance of digestion, absorption, immune, endocrine and metabolic absorption and digestion of nutrients, in order to make the body remained stable. The signal substance required for the association of intestinal flora with the organism may be part of the bacterial interaction or the metabolite produced by itself. When the intestinal flora disorder, the body may appear a series of diseases. It has a connection between the endocrine and immune related diseases such as type 1 diabetes, type 2 diabetes, and inflammation Enteritis, rheumatoid arthritis and intestinal flora disorder. As a important endocrine gland, it has a certain correlation between thyroid and the body hormone regulation which acts an important role in complex environment. There are many different kinds of thyroid diseases, the pathogenesis of symptoms are complex, at the same time the mechanism is not very clear, such as Graves's disease, Hashimoto's thyroiditis subacute thyroiditis, and so on. This article reviews the research progress of the relationship between the tyroid related diseases and disorders of the gut flora, in order to exploring the guiding significance of disease prevention, diagnosis and treatment.
2017 Vol. 4 (3): 349- [Abstract] ( 365 ) HTML PDF (1031 KB)  ( 372 )
353 Cancer survivors and cancer survivorship research in the United States
LU Weidong
Cancer survivors are persons living with cancer. It has become a reality that a cancer patient can live for many years after a cancer diagnosis due to the advancement of medical treatment and newly developed cancer drugs. Nevertheless, during and after the completion of anti-cancer therapies, and during the later follow-ups and monitoring the cancer recurrence, cancer survivors face unique physical, psychological, economic and social challenges. These issues include managing long-term toxicities and later effects of anti-cancer therapies; the changes from a cancer patient to a cancer survivor; the transition from cancer treatments to healthy living and the readjustment of their roles in the society and their families. In addition, many oncologists and community family physicians are not familiar with the concept of cancer survivorship with inadequate professional training. In past 30 years, the research and services of cancer survivorship is becoming an emerging branch of medicine in the United States and Europe, which comprises multidisciplinary professionals, governments, social services, cancer patients and their families. We reviewed and analysised the definition, history, development and current research of cancer survivorship in the United States. Comparing with the current cancer condition in China, we provided directions and perspectives of cancer survivorship research and services for the cancer community in China.
2017 Vol. 4 (3): 353- [Abstract] ( 322 ) HTML PDF (957 KB)  ( 163 )
359 Preoperative oral nutritional supplements of fast track surgery
SONG Xin-na, FENG Yan
The concept of the enhanced recovery after surgery was to reduce trauma stress and ccelerate patient rehabilitation by optimizing perioperative management. Good nutrition status was conducive for patients to reduce the decomposition metabolism, improve clinical outcome, is an important part of the enhanced recovery after surgery. Preoperative screening and evaluation of patients before operation, and then nutritional intervention in patients with malnutrition was necessary. However, there is some controversy about the best indicators or methods of nutritional status, and implementation was not optimistic. Oral nutritional supplements which was convenient to operation, easy to manage, lower complications, good compliance, was the first choice for nutrition intervention, at least 7 to 10 days before surgery. Preoperative oral nutritional supplements not only benefit patients with severe malnutrition, but also benefit from severe malnutrition in patients with cancer of the digestive system who lost weight before surgery. Although the role of immune nutrition has been confirmed, and the perioperative application of immune nutrition has become consensus, the advantages of preoperative immunonutrition compared to the standard isocaloric and isonitrogenous formula are challenged. At present, there is no optimal combination and formula of immune nutrition, and the preparation of the standard formula also contains certain immunonutritional components, so the selection of preoperative nutritional preparation should be based on the actual situation.
2017 Vol. 4 (3): 359- [Abstract] ( 352 ) HTML PDF  (0 KB)  ( 87 )
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