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2017 Vol. 4, No. 4
Published: 2017-12-09
 
364 Efficacy evaluation of nutrition therapy
As a fundamental care for patients, nutrition therapy should be and could be evaluated. Traditionally, plasma albumin level and body weight were the only two parameters assessing efficacy of nutrition therapy. Being an integrative treatment, functioning nutrition therapy impacts on patient’s physical, psychological, behavior, function, structure and disease lesion, besides nutrition status. Therefore, its therapeutic role should thus be evaluated comprehensively. This paper proposes to evaluate efficacy of nutrition from following aspects, nutrition knowledge-attitude-practice, food & feeding, nutritional status, anthropometry, body composition, physical performance and health status score, laboratory, psychological and quality of life. Additionally, cancer volume, biomarkers, metabolic activity and survival time should be specifically investigated for cancer patients. Due to the time difference of response, different parameters should be monitored in different time before nutrition, during nutrition and after nutrition dynamically.
2017 Vol. 4 (4): 364-370 [Abstract] ( 283 ) HTML PDF (1206 KB)  ( 178 )
371 Metabolism of tumor growth & metastasis
NING Tao, BA Yi
As we know, tumor is a metabolic disease. During tumor development, cancer cells need to increase the biosynthetic and bioenergetic demands to maintain tumor cell proliferation and metastasis. The focus has been mostly on the metastatic style of the primary tumor, while metabolic adjustments during primary tumor growth and metastatic process have been less well known. Present evidences indicate that metabolic regularity of tumor development is dynamic. Moreover, emerging data suggest that, once the tumor cells leave their primary sites, may show different metabolic styles, distinct from the primary tumor, to successfully survive and metastasis. In this review, we will summarize how the metabolic flexibility will be occurred during the primary tumor growth and metastatic process, and we will also explore how metabolic adaptation is influenced by the metastatic microenvironments. We hope that this review will give information for the tumor metabolic research in the future.
2017 Vol. 4 (4): 371-375 [Abstract] ( 228 ) HTML PDF (1024 KB)  ( 102 )
376 Protective mechanism of probiotics on radiation-induced intestinal injury
FAN Ming, YANG Jia-lin, LI Tao
Probiotics are live microorganisms which confer a health benefit on the host when administered in adequate amounts. They can be ingested as medications or dietary supplements to help maintain a balance in the microbial environment of the digestive tract. Probiotics can help maintain homeostatic, enhance physical fitness, thereby reducing the adverse effects caused by anti-cancer treatments. Recent studies have shown that probiotics can protect and alleviate radiation-induced intestinal damage by activating anti-apoptotic pathway AKT, activating COX-2 pathway to inhibit inflammatory reaction, protecting intestinal barrier, improving bacterial translocation and regulating intestinal micro-environment. Although relevant clinical trials of probiotics varied in the type of bacteria species, the concentration of live bacteria, and research methods, most of them demonstrated that probiotics could prevent radiation induced intestinal adverse effects. With the continuous improvement of comprehensive treatment of cancer, the survival time of patients has been prolonged. In recent years, how to alleviate the adverse reactions during and after treatment, alleviate the pain caused by treatment, and improve the quality of life has become increasingly prominent. Future research should focus on optimizing the flora configuration and addressing the safety on immunocom promised patients.
2017 Vol. 4 (4): 376-380 [Abstract] ( 294 ) HTML PDF (2454 KB)  ( 101 )
381 Impact of sarcopenia obesity on clinical outcomes in cancer patients
LI Yi, ZHOU Fu-xiang
There have been increasing studies regarding the influence of body composition on oncological patient outcomes. Terms such as sarcopenia, obesity and sarcopenia obesity have been used widely in present studies about clinical outcomes of oncological patients. Sarcopenia obesity, defined as the concurrence of sarcopenia and obesity, remained unclear in oncological patients. Recent researches have demonstrated that sarcopenia obesity is associated with the occurrence, development and prognosis of carcinoma. Early diagnosis and effective therapy can improve oncological patients’ clinical outcomes. As a consequence, further understanding of sarcopenia obesity is critical to direct better clinical work. This review described the relationship between sarcopenia obesity and adverse clinical outcomes in oncological patient. Of note, oncological patients with sarcopenia obesity tend to be with higher dose-limited toxicity, higher surgical complications and lower overall survival. More attention should been paid on sarcopenia obesity in these patients.
2017 Vol. 4 (4): 381-389 [Abstract] ( 287 ) HTML PDF (1367 KB)  ( 86 )
390 Radiotherapy and glucose metabolism of malignant tumors
GUO Jia-xing, YU Zhi-long, BAO Ying-na
There have been increasing studies regarding the influence of body composition on oncological patient outcomes. Terms such as sarcopenia, obesity and sarcopenia obesity have been used widely in present studies about clinical outcomes of oncological patients. Sarcopenia obesity, defined as the concurrence of sarcopenia and obesity, remained unclear in oncological patients. Recent researches have demonstrated that sarcopenia obesity is associated with the occurrence, development and prognosis of carcinoma. Early diagnosis and effective therapy can improve oncological patients’ clinical outcomes. As a consequence, further understanding of sarcopenia obesity is critical to direct better clinical work. This review described the relationship between sarcopenia obesity and adverse clinical outcomes in oncological patient. Of note, oncological patients with sarcopenia obesity tend to be with higher dose-limited toxicity, higher surgical complications and lower overall survival. More attention should been paid on sarcopenia obesity in these patients.
2017 Vol. 4 (4): 390-396 [Abstract] ( 235 ) HTML PDF (1473 KB)  ( 126 )
397 Dietary nutrition prescription for cancer patients
LI Zeng-ning, CHEN Wei, QI Yu-mei
Malnutrition and dyscrasia are very common in cancer patients. Malnutrition is associated with poor treatment tolerance, reduced opportunities for treatment, increased complications, increased morbidity and mortality, prolonged hospital stay, and lower survival rate. Malnutrition not only has an impact on the effect of treatment and quality of life, but also cause huge economic losses and waste of social medical resources. Nutrition therapy as a basic methods of clinical treatment and rehabilitation, has been proved by a large number of evidence-based medicine at home and abroad. The evidence shows that the reasonable and effective nutritional support will not increase the rate of tumor recurrence or metastasis rate and lower survival rate, but can significantly improve the postoperative cancer patients nutrition and immune status, reduce the incidence of complications and postoperative infection, improve the cure rate of patients, reduce the mortality rate, reduce drug and medical expenditure, has a positive for most malnourished cancer patients. In order to apply the medical nutrition therapy on patients with cancer to clinical practice, the consensus based on existing research on the relationship between cancer and nutrition at home and abroad, and combined with the status and characteristics of China's diet. Systematically summarize and analyze the influence of dietary nutritional factors on cancer patients and standardize the principles and steps of oncology nutrition treatment. Apply to clinician, clinical nutrition professionals, nurse, and other health care workers.
2017 Vol. 4 (4): 397-408 [Abstract] ( 483 ) HTML PDF (1239 KB)  ( 464 )
409 Nutrition intervention in advanced upper gastrointestinal cancer patients undergoing chemotherapy
XIN Xiao-wei, FANG Yu, GONG Li-qing
Objective To evaluate the effect of nutritional intervention on the nutritional status of patients with upper gastrointestinal cancer before and after chemotherapy. MethodsAdvanced upper gastrointestinal cancer patients (n=82) were screened and assessed by NRS 2002 and PG-SGA. According to the results of PG-SGA, the patients were divided into three groups: well-nourished (A), moderately malnourished or suspected of being malnourished (B) and severely malnourished (C). Nutritional intervention is based on the "five steps of malnutrition". Nutritional status, weight, energy and protein intakes of the patients were compared before and after chemotherapy. ResultsBefore intervention well-nourished patient was 10.98%(8/82), moderately malnourished or suspected of being malnourished was 50.00%(41/82), severely malnourished was 39.02%(32/82). The incidence of nutritional risk and malnutrition after intervention decreased, before intervention was 52.44% and 89.02% respectively, after intervention was 35.37% and 75.61% respectively. Compared to before chemotherapy, the weight of patients in well-nourished group and moderately malnourished or suspected of being malnourished group maintained stability, [(67.88±11.25) kg vs (67.22±10.17) kg, P>0.05 and (63.00±11.50) kg vs (62.58±11.48) kg, P>0.05], respectively. While in severely malnourished group, weight loss significantly [(59.92±9.61) kg vs (59.15±9.46) kg, P<0.05]. The average daily dietary intake of energy and protein increased significantly of moderately malnourished or suspected of being malnourished group and severely malnourished group, compared to before intervention (P<0.05) well-nourished group maintained stability (P>0.05). ConclusionsNutritional intervention can reduce the incidence of nutritional risk and malnutrition of patients with advanced upper gastrointestinal cancer, decrease weight loss, improve nutritional status, and may help to improve the clinical outcome.
2017 Vol. 4 (4): 409-413 [Abstract] ( 267 ) HTML PDF (1149 KB)  ( 81 )
414 Protein intake on body composition and quality of life in head and neck cancer patients undergoing radiotherapy
WANG Yan-li, GONG Li-qing, SHI Shuang
Objective To explore the effect of protein intake on the nutritional status, body compositionp and quality of life ofpatients with head and neck cancer treated by radiotherapy. MethodsThe patient-generated subjective global assessment method was adopted to evaluate the nutritional status of 83 patients with head and neck cancer before and after radiotherapy. Nutrition interventions (dietary guidance, ONS, PN) were also totally employed during their therapy. According to theiractual protein intake, these patients were divided into two groups, group A [≥0.8g/(kg·d)] and group B [<0.8g/(kg·d)]. The status of nutrition, assessment of body composition and quality of life before and after radiotherapy in two groups of patients were compared. ResultsThe incidence of malnutrition in two groups had no statistic difference before radiotherapy (P≥0.5). After radiotherapy, the incidence of malnutrition and the change of the grip force in A group were significantly lower than that in B group (P<0.05); Changes in body composition in A group were significantly lower than in B group, such as body weight, percentage change in body weight, BMI, percentage of fat body mass change, fat-free mass change, muscle mass change, and FFMI index (P<0.05); The quality of life scores in two groups had no statistic differencebefore radiotherapy; after the radiotherapy the changes of fatigue, insomnia, loss of appetite, pain, the overall quality of life in group A are better than in group B (P<0.05). ConclusionNutritional interventions can effectively maintain the nutritional status, improve continuously the physical strength and the quality of life in head and neck cancer patients with radiotherapy.
2017 Vol. 4 (4): 414-420 [Abstract] ( 204 ) HTML PDF (1095 KB)  ( 94 )
421 The sensitivity of the ketogenic metabolic therapy in cancer depends on the expression of ketolytic key enzymes
ZHANG Jie, CONG Ming-hua, GAO Yun
Objective Although ketogenic diet (KD) has been studied its certain anti-tumor effect by basic research and clinical trials, the specific molecular targets or indications which verify its anti-tumor activity are lack. In this study, we examined the expression of different ketolytic key enzymes to identify the sensitivity of KD in tumor cells. MethodsExpression of genes encoding 3-hydroxybutyrate dehydrogenase 1 (BDH1) and succinyl-CoA: 3-oxoacid CoA transferase 1 (OXCT1) have been determined in 33 human cancer cell lines by quantitative RT-PCR. HeLa cell and pan-1 cell were selected with high expressing and low expressing two enzymes respectively. Proliferation of HeLa and PANC-1 cells was determined by using a hand-held automatic cell counter after cultured in low glucose medium with or without DL-β-Hydroxybutyric acid sodium salt (βHB). BDH1 and OXCT1 were knocked down in HeLa cells by lentivirus-mediated RNA interference and established HeLa and PANC-1 cell xenograft tumors models in BALB/C nude mice to identify the sensitivity of KD in anti-tumor therapy. Results Compared to control group, proliferation of HeLa and PANC-1 cells in low glucose (LG) was significantly inhibited. Howevere, proliferation of HeLa cells was significantly increased, while added βHB into LG group, but there was no significant effect on proliferation of PANC-1 cells. Animal experiments demonstrated that KD inhibited growth of PANC-1 cell xenograft tumors dramatically, but no effect on the growth of HeLa xenograft tumor. Down-regulation of both BDH1 and OXCT1 in HeLa cells rendered their sensitivity to KD in vitro and in vivo. ConclusionsTumors with low expression of ketolytic enzymes which are not obviously induced gene expression are sensitive to ketogenic metabolic therapy.
2017 Vol. 4 (4): 421-429 [Abstract] ( 386 ) HTML PDF (3747 KB)  ( 140 )
430 Nutrition on metabolism of endometrial cancer patients with cachexia
WANG Xiao-hui, SUN Chao
Objective To investigate the metabolic changes of cachexia in women with advanced endometrial cancer by nutritional intervention. Methods70 patients with advanced endometrial cancer cachexia were randomly selected in our hospital from June 2015 to June 2017 were randomly divided into control group and experimental group, the control group using conventional self feeding intervention, the experimental group with nutrition intervention, the nutrition indexes and the metabolism related indexes before and after intervention, and statistical analysis the difference. ResultsAfter comparing the difference between the value of the nutritional indexes of BMI, blood cells, serum albumin, hemoglobin group before and after the intervention was not statistically significant (P>0.05); The experimental group before and after the intervention of the nutrition indexes between the values of the differences were statistically significant (P<0.05). Before the intervention experiment group before intervention and nutritional value index differences between each index value of the control group were not statistically significant (P>0.05), but after the intervention group were significantly higher than the nutritional value index after the intervention control group each index value, the differences were statistically significant (P<0.05). Compared with the control group before and after the intervention of waist circumference, high density lipoprotein, triglyce ride, systolic pressure, diastolic pressure, the difference between the blood glucose index was not statistically significant (P>0.05); The experimental group did each prognostic index for waist circumference, high density lipoprotein, triglycerides, blood glucose levels were significantly higher than the experimental group before the intervention of each index value. The differences were statistically significant (P<0.05), but no statistically significant difference in systolic blood pressure and diastolic blood pressure between the two groups (P>0.05); The experimental group before the intervention of waist circumference, high density lipoprotein, triglyceride, systolic blood pressure, diastolic blood pressure, blood sugar index before and after the difference between the index value of the control group were not statistically significant (P>0.05). Do the test group of prognostic index for waist circumference, high density lipoprotein, triglycerides, blood glucose values were significantly higher than the control group after intervention of each index value, the differences were statistically significant (P<0.05), but the systolic blood pressure and diastolic blood pressure in the stem was not statistically significant differences between prognosis of the experimental group and the control group (P>0.05). ConclusionNutritional intervention can significantly improve the nutritional status and metabolic markers in patients with advanced endometrial cancer cachexia.
2017 Vol. 4 (4): 430-434 [Abstract] ( 260 ) HTML PDF (1432 KB)  ( 75 )
435 Effects of short peptide enteral nutrition on recovery of intestinal mucosa damage induced by methotrexate in mice
WANG Zhong,ZHANG Chuan, LIANG Qing-yue
Objective To explore the nutritional effect of short peptide enteral nutrition on intestinal mucositis rats. Methods42 model of intestinal mucosa was established by methotrexate injection. SD rats were randomly divided into blank control group (n=14) and control group (n=14). Successful models were randomly divided into 3 groups: normal diet group, protein enteral nutrition group, short peptide enteral nutrition preparation group. Rats were given daily diets of 38kcal/100g. The serum levels of total protein, albumin, proprotein, transferrin and retinol were measured in the tail of rats at day 0, 3, 9 and 15 days after feeding. Protein and diamine magnesium oxide, and the rats were sacrificed 15 days after feeding, and pathological examination was performed to evaluate the intestinal injury. ResultsThe model of intestinal mucosal injury was established by methotrexate injection. The body weight and feeding rate of the short-peptide-type were better than those of the normal diet group and the integrated protein group (P<0.05). The rats were sacrificed at day 15, and the serum total protein, albumin, proprotein and transferrin were measured (P<0.05), and the diamine oxidase was decreased (P<0.05) compared with normal feeding and integrated protein group, while HE staining and short peptide. The damage of the internal nutrition group was lighter than that of the other two groups. ConclusionsPeptide preparation for intestinal mucosal injury is not only beneficial to the improvement of nutritional status in rats, but also contributes to the recovery of injury.
2017 Vol. 4 (4): 435-440 [Abstract] ( 288 ) HTML PDF (1150 KB)  ( 87 )
441 Changes of serum β-CTX levels in non-small cell lung cancer with bone metastasis after treated by Zoledronic acid combined with chemotherapy
PAN Xing-xi, YANG Wen, CHEN Yong-fa
Objective To investigate the clinical significance of βisomer of C-terminal telopeptide (β-CTX) in Zoledronic acid (ZOL) combined with chemotherapy for non-small cell lung cancer (NSCLC) with bone metastasis. MethodsNewly diagnosed NSCLC patients with bone metastasis (n=60) were randomised to the test group (n=30), who received ZOL combined with chemotherapy, or a control group (n=30), who received chemotherapy alone. Serum β-CTX was measured by ELISA before and after treatment in two groups. ResultsThe total effective rate was 90.00% in the treatment group were higher than that of the control group (63.33%) (P<0.05). The level of β-CTX after treatment in treatment group was lower than that before treatment (P<0.05), while in control group had no significant difference (P>0.05). ConclusionZOL administered with chemotherapy can more effectively reduce β-CTX levels for NSCLC patients with bone metastasis. Indicating that the change of β-CTX might be as a valuable index to ZOL for the treatment of NSCLC patients with bone metastasis.
2017 Vol. 4 (4): 441-444 [Abstract] ( 241 ) HTML PDF (1047 KB)  ( 104 )
445 Mitochondrial metabolism regulation: the anti-cancer mechanism of heat-clearing and detoxicating herbs JC724
DENG Li, RAO Ben-qiang
Objective To clarify the mechanism of cancer treatment by detoxicating herbs JC724. Methods Colorectal cancer cell eukaryotic RNA expression change was analyzed usinghigh-throughput technique after HT-27 cell treated 1h by JC724, a kind of detoxicating herbs, which had a definiteinhibit ted effect to colorectal cancer in our previous studies. Results The effect of JC724 on colorectal cancer cells showed significant difference in 25 gene expression, which were claudin-4 genes and other mitochondrial metabolism genes, such as MT-CO1 and MT-CO2 gene, MT-ND4L, MT-ND1 and MT-ATP8P1 genes. There was a significant difference in the expression of 324 gene after HT-29 cell treated 1h by Spreading hedyotis herb, which was the “jun drug” in JC724, including 95 up-regulated genes and 229 down-regulated genes. The top up-regulated genes and top down-regulated genes associated with mitochondrial metabolism were MT-CO1, MT-CO2, MT-ND1, MT-ND2, MT-ND4L, MT-ATP8P1, BCL2L1and BBC3. Compared with the Spreading hedyotis herb group, there was detected significant differences in the expression of 126 genes in the JC724 group, including 47 up-regulated genes and 79 down-regulated genes. ConclusionsIt showed the characteristics of complex system, the integrity, non-additivity and multi-targetting in the treatment of tumor for Chinese medicine, and the main molecular mechanism is closely related to regulate mitochondrial metabolism in the treatment of cancer by detoxicating herbs JC724.
2017 Vol. 4 (4): 445-452 [Abstract] ( 254 ) HTML PDF (1577 KB)  ( 85 )
453 Malnutritional status in lung cancer patients
YI Hai-wei, MA Dong-bo, SONG Yue
Objective To investigate the nutritional status of lung cancer patients, and to find the relationship of malnutrition, body composition and laboratory index. MethodsFrom March 2016 to May 2017, we collect 124 patients with lung cancer and 105 lung non-tumor patients in Lianyungang first people’s hospital, The nutritional status was evaluated by patient-generated subjective global assessment (PG-SGA), the body composition was measured by body composition analyzer and in the meantime, laboratory index were evaluated. ResultsAmong the 124 lung patients, 40.3% of the lung cancer patients were suspicious or moderate malnutrition and 44.4% of the lung cancer patients were severe malnutrition. The incidence of malnutrition was higher in lung cancer patients than in patients with lung non-tumor diseases, and the difference was statistically significant (χ2=24.3, P<0.05). Body weight, body mass index, lean body mass, body fat mass, hemoglobin, albumin, prealbumin in malnutrition patients were lower than those in lung non-tumor patients (P<0.05). The score of PG-SGA was inversely related to body composition index , albumin and prealbumin (P<0.05). The correlation between PG-SGA score and hemoglobin was not statistically significant (P>0.05). ConclusionsThe incidence of malnutrition was high in lung cancer patients. The score of PG-SGA is negatively correlated with body composition index, albumin and prealbumin. PG-SGA is a simple and effective tool to evaluate the malnutrition of lung cancer patients. Nutritional assessment, including PG-SGA, is recommended for patients with lung cancer to provide evidence for nutritional treatment.
2017 Vol. 4 (4): 453-457 [Abstract] ( 307 ) HTML PDF (1063 KB)  ( 86 )
458 The level of thyroid hormone and albumin after nutrition supportive therapy in perioperative gastrointestinal cancer patients
WAN Ying
Objective To study the effects of parenteral nutrition support in patients with gastrointestinal cancer during the perioperative period of thyroid hormone and prealbumin (PA) levels. MethodsFrom May 2013 to July 2016, 80 cases with gastrointestinal cancer treated in our hospital were randomly divided into the observation group and the control group, with 40 cases in each group. The observation group was given parenteral nutrition support after operation, and the control group was not given parenteral nutrition support. The preoperative 1 day, postoperative 1 day, postoperative 5 days and thyroid hormone and PA levels in the two groups were detected before and after operation respectively in the patients of the two groups, respectively. The results showed that the patients in the control group were not given parenteral nutrition support after operation. The levels of thyroid hormone and 8 days in the two groups were detected before operation, after the operation, after the operation and after the operation.The particle analysis method for detecting free triiodothyronine three capture ELISA (FT3) and total three triiodothyronine (TT3), detection of reverse triiodothyronine three by radioimmunoassay (rT3) and the level of PA. The correlation analysis was done. ResultsThe observation group preoperative 1D, postoperative 1 day, postoperative 5 days and postoperative 8 days, FT3, TT3, rT3, PA level, using the analysis of variance of repeated measurement data, the results showed that: different time points of FT3, TT3, rT3, PA level differences were statistically significant (P<0.05).The control group preoperative 1D, postoperative 1 day, postoperative 5 days and postoperative 8 days, FT3, TT3, rT3, PA level, using the analysis of variance of repeated measurement data, the results showed that: different time points of FT3, TT3, rT3, no significant difference in PA levels (P>0.05). Pearson correlation analysis showed that the FT3, TT3 and PA levels in the observation group were positively correlated (r=0.473, P<0.01; r=0.502, P<0.01) at different time periods, while the rT3 and PA levels were negatively correlated (r=-0.424, P<0.05). ConclusionThe gastrointestinal cancer patients before the existence of non thyroid disease syndrome, and in a short period after operation can not be fully restored. In addition, parenteral nutrition support in patients with gastrointestinal cancer during the perioperative period of thyroid hormone and PA levels have obvious changes, can be used as one of the evaluation indexes of patients with perioperative nutritional status.
2017 Vol. 4 (4): 458-462 [Abstract] ( 278 ) HTML PDF (1062 KB)  ( 74 )
463 Individualized diet guidance on recovery and quality of life in patients with lower extremity surgery
YU Jing
Objective To study the effect of individualized diet guidance on the quality of rehabilitation and quality of life scale in patients with lower extremity surgery. Methods84 cases were selected from May 2015 to May 2016 in our hospital for the treatment of hip arthroplasty, and 42 cases were divided into observation group and control group according to the random number table method. The patients in the control group was given routine nursing intervention, and the observation group underwent postoperative individualized diet guidance. The function of hip joint, daily life activity, mental state, incidence of postoperative complications and QOL score were compared between the two groups. Resultsafter the individual dietary guidance, the Barthel index and Harris score of the observation group were (84.7±8.0), (81.5±10.3), respectively, which were significantly higher than those in the control group (73.4±8.2), (72.6±8.9), the differences were statistically significant (P<0.05). After dietary guidance, the SAS and SDS scores of the observation group were (29.8±3.1), (22.1±1.8) respectively, which were significantly lower than those in the control group (38.2±4.5), (31.5±2.4), the differences were statistically significant (P<0.05). The complication rate of observation group was 9.52% (4/42), significantly lower than the control group 30.95% (13/42), the difference was statistically significant (P<0.05). Nutritional care after the observation group and the control group of patients with QOL score respectively (50.3±5.4), (30.7±5.0), were significantly higher than that of individual diet the guidance, while the observation group was significantly higher than the control group, the differences were statistically significant (P<0.05). Conclusionindividualized dietary guidance after operation can effectively improve the rehabilitation quality of patients undergoing lower limb surgery, relieve psychological negative emotions, reduce the incidence of complications and quality of life.
2017 Vol. 4 (4): 463-467 [Abstract] ( 223 ) HTML PDF (1061 KB)  ( 68 )
468 Perioperative precision nutritional therapy for gastrointestinal cancer patients
LI Yun-long, WANG Shi-qi, ZHAO Qing-chuan
The incidence of malnutrition in patients with malignant tumors is high, especially in patients with gastrointestinal cancer. In addition to the consumption of tumor itself and the release of specific factors, gastrointestinal tumors are often caused by inadequate or excessive loss of nutritional intake due to obstruction of the digestive tract, which further aggravates the degree of malnutrition in the patients. Perioperative malnutrition can increase the incidence of postoperative complications, prolong hospital stay, reduce quality of life, increase unplanned second surgical rates, and ultimately increase mortality. By using of effective nutrition screening tool for scanning patients with malnutrition, providing accurate and effective nutritional support treatment in the perioperative period, improving the nutritional status of patients with tumor, it can improve the tolerance of patients with tumor, reduce the adverse reaction and complication rate, improve curative effect, shorten hospitalization time, reduce hospitalization costs, thereby improving the clinical outcome of patients, and improve the quality of life and prolong the survival time. Therefore, perioperative nutrition screening and accurate nutrition therapy for gastrointestinal cancer patients are of great importance to improve the prognosis of patients with gastrointestinal cancer. From the aspects of the causes of malnutrition in patients with gastrointestinal cancer, the assessment and screening of nutritional status, the precision nutrition therapy, and the choice and application of the nutritional preparations, this paper illustrates the current research progress.
2017 Vol. 4 (4): 468-471 [Abstract] ( 232 ) HTML PDF (1049 KB)  ( 96 )
472 Vitamin D3 and gastrointestinal tumor
ZHANG Yong-xin, CHEN Hao, XIONG Yong-qiang
The structure of vitamin D3belongs to steroid hormone. Its main physiological function is regulating calcium and phosphorus metabolism and maintaining normal blood calcium levels, regulating bone metabolism and physiological reaction of many cells. In recent years, many studies have shown that vitamin D3plays an important role in many kinds of tumors, affecting tumor cell proliferation, apoptosis and other activities. The mechanisms by which vitamin D3acts on different cancer cell types strongly suggest that vitamin D3may play a protective and antitumor role, delaying cell transformation, proliferation, and cancer progression. Epidemiological studies have found that serum vitamin D levels are negatively correlated with the risk of gastrointestinal cancer, and serum vitamin D levels are positively correlated with the prognosis of patients with gastrointestinal cancer. Further studies have shown that vitamin D3can induce apoptosis, block cell cycle and inhibit proliferation of gastrointestinal cancer cells in a variety of ways. Vitamin D3 can cooperate with chemotherapeutic drugs to promote tumor cell apoptosis and inhibit tumor cell proliferation. Compared with vitamin D3, vitamin D3has less side effects and can play its role in inhibiting the growth of tumor cells. Vitamin D3may exert its antitumor effect through vitamin D3 receptor VDR. In combination with these studies, vitamin D3is expected to become a new approach for the treatment and prevention of gastrointestinal tumors, and more vitamin D3 anti-tumor mechanisms and clinical trials can bring good news for patients with gastrointestinal cancer.
2017 Vol. 4 (4): 472-476 [Abstract] ( 291 ) HTML PDF (1131 KB)  ( 86 )
477 Liquid biopsy in precision medical care of lung cancer
BAI Lu, DENG Chuan-sen, HU Xiao-tian
Lung cancer is one of the most common malignancies in the world. It is also one of the highest incidence, the highest mortality rate, the fastest growth rate and the worst prognosis malignancies. In many countries, the incidence and mortality of lung cancer have been significantly increased. The incidence and mortality of lung cancer in men are the highest among all malignant tumors. The incidence of lung cancer ranks the second place with the second highest death rate. For more than ten years, liquid biopsy has become a hot spot in the precision medical care of lung cancer because of its small trauma, low cost and high sensitivity. At present, the application of liquid biopsy in precision medical care of lung cancer mainly includes the detection of circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) and exosomes. Among them, CTCs is not only an effective method for early diagnosis of lung cancer, but also can be used as a potential prognostic indicator of lung cancer staging; ctDNA can not only serve as a feasible tool for the diagnosis of lung cancer, reference indicators for personalized treatment, but also as a tumor potential biomarkers help predict postoperative recurrence; exosomes are widely recognized as potential tumor biomarkers in the blood and are extremely important for the early diagnosis, treatment and prognosis of lung cancer, and may even be used as a treatment for lung cancer potential target. This article reviews the biological characteristics and clinical application of CTC, chloroplast DNA and exosomes based on different liquid biopsy biomarkers.
2017 Vol. 4 (4): 477-482 [Abstract] ( 297 ) HTML PDF (1153 KB)  ( 78 )
483 Sarcopenia and gastrointestinal cancer
YU Jing, ZHOU Fu-xiang
Sarcopenia is a clinic syndrome mainly characterized by skeleton muscle mass and function loss, which is common in the elderly, malnutrition, chronic inflammation and cancer. Malnutrition and sarcopenia are common in cancer patients, especially in gastrointestinal tumors. This paper was to investigate the incidence of sarcopenia and the influences of sarcopenia on treatment-related side effects and prognosis, further to clarify its clinical significances in gastrointestinal cancer patients. Key words such as “sarcopenia” and “cancer” were reviewed in “CNKI” and “Pubmed” databases. The results suggested that, firstly, sarcopenia was prevalent in gastrointestinal cancer, however, diagnostic criteria for sarcopenia were variable, and the standard diagnostic criterion for sarcopenia should include muscle mass assessment and functional status assessment. Secondly, sarcopenia had negative impact on tolerance to treatment and prognosis, including higher risk of severe chemotherapeutic toxicity, more surgical complications, longer length of stay in hospital and shorter survival. In conclusion, the assessment of sarcopenia is essential in gastrointestinal cancer patients, and may become an important means to predict the clinical outcomes of gastrointestinal cancer. Otherwise, it also suggest that clinical intervention on sarcopenia is of great significance.
2017 Vol. 4 (4): 483-488 [Abstract] ( 338 ) HTML PDF (1040 KB)  ( 140 )
489 Nutrition assessment in malignant digestive cancer patients
MA Xiao-ye, FANG Xiu-xin, WANG Xiao-xiao
The incidence of malignant tumors of digestive system have accounted for about 1/3 of all malignant tumors so far, and become an enormous public health burden. Following lung cancer, digestive system malignancies have become the second leading cause of death due to cancer. Patients suffering from digestive system malignancies frequently have complication characterized by malnutrition, which have become a worldwide problem. Malnutrition is a continuous process which is easily ignored during hospitalization. Recently, accumulated studies have suggested that malnutrition had negative effects on both operation process and post-operation healing, which mainly attributed to poor clinical outcome. Considering the therapeutic strategy of malnutrition which includes early detection and intervention, it is of great importance to evaluate the nutritional status of patients with malignant tumors of digestive system in time. The review first introduced the definition and diagnosis of malnutrition followed by the elucidation of prevalence, causes and effects of malnutrition for patients with malignant tumor of digestive system. More importantly the review focused on elaboration of studies about malnutrition evaluation in methods, character and application status, as well as the summarizing the reports on APMT. This review introduces the definition and diagnosis of malnutrtion , and made a comment on the prevalence and causes and effects of the malnutrition for patients with malignant tumor of digestive system and the character and situation of the application with the common nutritional assessment methods home and aboard. And it also introduces the assessment of the thickness of adductor pollicis muscle from abroad.
2017 Vol. 4 (4): 489-492 [Abstract] ( 240 ) HTML PDF (1285 KB)  ( 312 )
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