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2018 Vol. 5, No. 3
Published: 2018-09-09
 
225 Fighting malnutrition in hospital: an introduction to hunger-free hospital programme Hot!
SHI Han-ping, CHEN Wei, YANG Liu-qing, CONG Ming-hua, WANG Kun-hua, LI Yong, LI Wei, LI Zeng-ning, YANG Qin-bing,
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.001
Malnutrition is frequently found in hospital settings with alarming high prevalence rate. Of note, hospitalized patients have highest malnutrition incidence rate among population groups. 20%~60% patients have malnutrition at the time of admission, 30%~80% patients have in-hospital weight loss, indicating patients have nosocomial malnutrition (NM) or hospital acquired malnutrition (HAM) during hospital stay, all of which exacerbates DRM. Hungry-free hospital (HFH) is a nutrition care delivery program, with its focus on providing high-quality patient care, to ensure patients get easy access to safe, affordable, nourishing meals during hospital tasty, to reduce hunger or hidden hunger, to efficiently prevent HAM, to ensure inpatients receive proper nutrition therapy, and to effectively treat DRM. HFH is a comprehensive program, comprising with improving recognition of the adverse effects of malnutrition, develop a simple and easy-to-use clinical diagnostic tool, reinforce multimodal strategies for nutrition screening at admission, achieve higher completion rate of nutrition assessment, setting up NST and NSC, implementing nutritional nutrition consultation costing system, provide RUSF and RUTF, optimizing clinical examination and treatment time, develop a HFH evaluation system, and implementing continuous quality improvement (CQI) in hospital. In this article, HFH program consisted of four key approaches related to HFH efficient implementation: firstly, from nutrition science point of view, standardise key terms in clinical nutrition; secondly, address and apply standard clinical nutrition care process; thirdly, improve hospital administration management. Finally, reinforce hospital catering services. HFH is a multi-level approach involving professionals in clinical setting, staffs in catering system, patients and family members into HFH. Ultimately, promotion of a multi-level approach to hospital malnutrition at society level to raise awareness of the public as a whole, maximising hospital service quality and improving patient satisfaction.
2018 Vol. 5 (3): 225-230 [Abstract] ( 673 ) HTML PDF (1147 KB)  ( 608 )
231 Diagnosis and treatment of tumor cachexia
WU Hai-tao, WANG Chang, LI Wei
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.002
The cachexia of tumor patient is characterized by skeletal and visceral muscle consumption in cancer patients. It is accompanied or not accompanied by loss of appetite, anorexia, feeling of fullness, weight loss, muscular atrophy, fatigue, anemia, edema, hypoproteinemia and a series of clinical complications. The existence of tumor cachexia makes it difficult for patients to carry out anti-tumor therapy and reduces the survival of patients. Meanwhile, the appearance of clinical complications also seriously reduces the quality of life of them. The morbidity and the mortality of cachexia in tumor patients is high, and it is difficult toreverse once entering the period of cachexia in clinical. Therefore, it can be improved the weight and reduced the muscle loss, alleviated the symptoms of cachexia, improved the quality of life, prolonged the survival and improved the prognosis by the early intervention. Based on the definition of tumor cachexia,starting from the metabolic changes of the three major nutrients, the possible pathogenesis of tumor cachexia is summarized in this manuscript, And then it described the screening, evaluation and diagnosis of tumor cachexia. The treatment strategies and methods are summarized, including nutritional intervention, exercise intervention, psychological intervention and other drug intervention, and so on. The prospect of multidisciplinary treatment (MDT) of tumor cachexia in the future is also discussed. It is expected to provide a new idea and create a new platform for early diagnosis and treatment, prolong survival and improve prognosis of patients with tumor cachexia.
2018 Vol. 5 (3): 231-235 [Abstract] ( 437 ) HTML PDF (1052 KB)  ( 453 )
236 Cancer related fatigue diagnosis and treatment
TAN Shan-yue, LIU Ling-xiang
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.003
Fatigue is a common problem in cancer patients. Main factors contributing to CRF are progressive tumor, cytotoxic chemotherapy, biologic response modifiers, molecularly targeted therapy (particularly the small molecular tyrosine kinase inhibitors and monoclonal antibodies targeting the VEGF/EGFR), radiotherapy, anemia, pain, emotional distress, sleep disturbance, and malnutrition. Therefore, CRF screening and treatment has become the focus of supportive care in contemporary cancer treatment. Here, we systematically reviewed definitions, epidemiology, pathogenesis, screening, clinical assessment and treatment of CRF in cancer survivors. Moreover, management of CRF includes specific treatment for potentially reversible causes (treating anemia, metabolic or endocrine abnormalities, as well as managing pain, insomnia, depression or anxiety) and symptomatic treatment. Nonspecific symptomatic treatment includes education, counseling, pharmacologic (eg. psychostimulants and other wakefulness agents) and nonpharmacologic (eg. exercise, yoga, acupuncture) approaches. To be more important, we focus on exercise therapy, treatment of anemia, improvement of sleep disorders, psychological cognitive interventions, physical and psychological interventions, medical therapy and Chinese traditional medical treatment. Up to now, exercise therapy is the most effective therapy. Furthermore,
the individualized moderate aerobic exercise can improve CRF in most patients with CRF, if exercise is not contraindicated.
2018 Vol. 5 (3): 236-239 [Abstract] ( 428 ) HTML PDF (1202 KB)  ( 365 )
240 New progress in the treatment of gastroparesis
CHEN Jun-qiang, WANG Zhen
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.004
 Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of nausea, vomiting, early satiety, bloating and abdominal pain, which is caused by delayed gastric emptying. These chronic symptoms have adverse impacts on the physiology, psychology and life quality of patients. Studies found that the mortality of patients with gastroparesis was higher than those without gastroparesis, which showed that gastroparesis has become a serious threa to human health. In last decade, there were some updates on the pathogenesis and management of gastroparesis. Studies found that gastroparesis were associated with decreased interstitial cells of Cajal (ICC), which caused the insufficience and allorhythmia of smooth muscle cells in the antrum. Therefore, endoscopic implantable gastric electric stimulator or pyloroplasty should be the choice for refractory gastroparesis. In addition, researchers found that some patients with gastroparesis who did not respond to drugs or surgery benefitted from immunotherapy. Not surprisingly, patients suffering from chronic gastrointestinal conditions frequently report psychological symptoms, such as anxiety and depression. So psychological evaluation and management should be considered for patients with gastroparesis. Moreover, identifying the risk factors of gastroparesis might help prevent occurrence of gastroparesis. At last, exploring novel treatment methods, such as stem cell transplantation, may bring new hope for gastroparesis.
2018 Vol. 5 (3): 240-246 [Abstract] ( 401 ) HTML PDF (1022 KB)  ( 398 )
247 Biomarkers of carcinemia and cancer treatment related complications
1LIU Jin-peng 2LU Xiao-Lan
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.005
Cancer cachexia is a multifactor syndrome involving multiple systems in the whole body. It is manifested in the loss of skeletal muscle mass, while traditional nutritional support can not be completely reversed, which leads to continuous deterioration of functional damage, resulting in loss of weight, immune function and resistance to cancer treatment, which is a common complication of cancer patients and the main cause of death. At the same time, when the cancer patients receive active treatment such as chemotherapy, radiotherapy and others, the treatment has a certain traumatic effect, so the risk of the treatment
related complications is very high, which often leads to a decline in patient tolerance and compliance, which will affect the follow-up treatment, and even more serious may endanger the life of patients. Thus it can be seen, carcinemia and cancer treatment related complications are the two major problems that currently plaguing cancer treatment.It is highly demanded that cachexia be diagnosed, its progression be monitored and the complications of cancer treatment be predicted timely at present. As we all know, the determination of biomarkers can be used to understand the biological processes in the body, so biomarkers have unique advantages in identifying accurate, sensitive and low levels of damage. Moreover, the recognition of biomarkers’ significance in carcinemia and
its treatment related complications could facilitate the prevention of carcinemia and the adjustment of cancer treatment programs effectively.
2018 Vol. 5 (3): 247-250 [Abstract] ( 442 ) HTML PDF (968 KB)  ( 350 )
251 Interpretation of expert consensus on nutrition therapy pathway for malignant tumors in China: totally implantable venous accessports
CHEN Hong-sheng, LV Qiang, WANG Lei, ZHAO Jin-lu, XIAO Hong-qi, DANG Shu-wei, LIU Ming
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.006
Totally implantable venous accessports (TIVAP) is a kind of deep vein infusion device implanted subcutaneously. It mainly includes venous poraccess system and an injection port for puncture. Venous access ports are able to provide safe, convenient, beautiful as well as long-term portable vascular access for those patients suffering from long-term infusion of chemotherapy drugs or parenteral nutrition, also for patients who need chronic transfusion due to chronic diseases. It has the advantages of low risk of infection, convenience for patients, reduction of the number of puncture vessels, simple maintenance and long service life. With the continuous progress and development of TIVAP, this technology has been accepted and applied by many clinical workers in China. However, there have been controversies in several aspects including making decisions of the implantation method and its route of venous access ports, the dosing interval after venous access ports implantation and whether antibiotics are supposed to be applied prophylactically prior to venous access ports implantation. Besides, the application of venous access ports in paediatric patients has triggered some dispute as well. Therefore, this article interprets the Expert Consensus on Nutrition Therapy Pathway for Malignant Tumors in China, and proposes suggestions on the methods of port implantation, post-implantation use and perioperative
management, offering guidance for the application of venous access ports in clinical practice, contributing to making optimal choice in nutritional treatment pathways for patients with malignant tumors according to the latest consensus.
2018 Vol. 5 (3): 251-256 [Abstract] ( 653 ) HTML PDF (1014 KB)  ( 873 )
257 Nutritional intervence on nutritional status, swallowing function and life quality in patients with swallowing dysfunction after stroke
YE Le-le
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.007
 ObjectiveTo study the effect of intervence nursing on nutritional status, swallowing function and life quality in patients with dysphagia after stroke. MethodsEight-four patients treated in our hospital from April 2015 to April 2017 were selected as our observational objects in this study. They were divided into two groups by digital randomization method: observation group and control group. The control group was treated with conventional flow-infusion through the stomach tube and other routine intervence. Patients in the observation group were treated with the high-quality nutritional intervence of high-quality enteral nutrition preparations. After two weeks, the effects were evaluated. The nutrition indexes such as serum albumin (ALB) and total protein (TP) after intervence were compared, the results of drinking water test in depression were compared before and after nursing and the comprehensive clinical efficacy was evaluated. The quality of life after intervence was evaluated using the MOS item short from health survey, SF-36. ResultsThe total effective rate of swallowing function recovery in the observation group after intervence was 90.48%, which was significantly higher than that in the control group (78.57%), and the difference was statistically significant (P<0.05); there was a statistically significant difference in the drinking water test ratings between the two groups after intervence, and the observation group was significantly better than the control group (P<0.05); the ALB, TP and total lymphocyte count (TLC) in the observation group were significantly better than those in the control group. The difference was statistically significant (P<0.05). The social, physiological function, general health, physiology, emotional function, vitality score, mental health and physical pain scores in the observation group were significantly higher than those in the control group, and the difference was statistically significant (P<0.05). ConclusionsHigh-quality nutritional intervence can significantly improve the nutritional status and swallowing function in patients with dysphagia after stroke, significantly improve life quality, and can be used for clinical promotion.
2018 Vol. 5 (3): 257-260 [Abstract] ( 385 ) HTML PDF (1352 KB)  ( 342 )
261 Clinical application and analysis of different nutritional intervention in gynecologic tumor patients during perioperative period
1QIN Nan 2JIANG Gui-chun
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.008
ObjectiveTo investigate the clinical application of nutritional intervention in gynecologic tumor patients during perioperative period. Methods90 patients with gynecologic cancer treated in our hospital from January 2017 to July 2017 were selected as the object of study. All patients were treated with symptomatic surgery. Be in accordance with the nutritional intervention time and method, the patients were divided into observation group (n=45) and control group (n=45), the control group received the way of routine preoperative fasting and nutritional support 6h after, patients in the observation group received the way of nutrition support form the preoperative 4 days. Two groups of patients respectively on admission, 7 days after operation and 14 days after operation after admission of the nutritional status of SGA scale (subjective global assessment) and objective indicators of nutritional status (including number of lymphocytes, albumin, transferrin, prealbumin, hemoglobin) for a reasonable evaluation and indicators related to the operation and follow-up were compared between the two groups of 6 the quality of life (SF-36). ResultsAt the time of admission, no significant differences between the two groups of patients with SGA scale and objective nutritional status index (P>0.05), 7 days after operation and 14 days after operation, the two groups of patients with normal nutrition, mild malnutrition and moderate malnutrition SGA scale index and objective nutritional index was significantly better than that of admission, the observation of SGA scale group 14 days after operation and objective nutritional status index of optimal difference (P<0.05); by comparison, the observation group of patients with intestinalperistalsis recovery time, exhaust time and weight related indicators significantly better than the control group, the difference was significant (P<0.05); in addition, found in two groups of patients were followed up for 6 months to observe. The short-term quality of life group patients were significantly better than the control group (P<0.05). ConclusionsEarly nutritional nursing intervention in the perioperative period in patients with gynecological tumors play an important role, which can not only improve effectively the nutritional status of patients, and to a certain extent, but also can improve the quality of life of patients.
2018 Vol. 5 (3): 261-264 [Abstract] ( 343 ) HTML PDF (952 KB)  ( 397 )
265 Investigation on nutritional K-A-P of nursing staff in tumor specialty in Hebei
ZHANG Xiao-wei, CHENG Xue-jiao, LI Yao, GUO Jian-wei
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.009
Objective To understand the status of nutritional K-A-P of tumor nursing staffs in Hebei Province and provide the basis for the training of tumor nutrition education. Methods A total of 652 tumor nursing staffs from 23 hospitals in Hebei Province were randomly selected to conduct a questionnaire survey on nutritional knowledge, attitudes and behaviors, and then analyzed the results systematiclly. Results The score of nutritional knowledge of nursing staffs was 16.38±9.19, and the passing rate and the excellent rate were both 0%. The score of nutritional attitude was 77.34±11.56, and the passing rate and the excellent rate were 95.74% and 17.02%, respectively. The score of nutritional behavior was 51.81±14.16, and the passing rate and the excellent rate were 27.66% and 4.26%, respectively. Compared to the years of work, there was a significant difference in the score of nutritional attitude between nursing staffs of different working years (F=3.804, P=0.030). Among them, nurses who have been working for 10-15 years have the highest nutritional attitude score. While the nutritional knowledge (F=0.698, P=0.503) and practice (F=1.542, P=0.225) score showed no significant difference. The top three approaches to obtaining knowledge of nutrition were groping for accumulation in work practice (79.37%), learning in school (71.43%), attending conferences and training (57.14%). Conclusions The tumor nursing staffs have a positive attitude towards nutrition therapy, but it is necessary to strengthen their skills of nutrition knowledge and practice. It is urgent to organize effective nutrition trainings for tumor nursing staffs.
2018 Vol. 5 (3): 265-268 [Abstract] ( 338 ) HTML PDF (978 KB)  ( 316 )
269 Postoperative application of “all in one” parenteral nutrition solution in patients with rectal cancer
ZHANG Qing, LIU Xiao-yu, LI Jing, CHEN Jun
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.010
Objective To analyze the effect of Clinomel “all in one” parenteral nutrient solution in the recovery period of postoperative rectal cancer. Methods 60 cases of open rectal cancer treated in our department from January 2017 to October 2017 were selected as research subjects, which randomly divided into the observation group (n=30) and control group (n=30), the observation group with Clinomel “all in one” nutrition prescription, the control group with normal nutrition, then respectively monitor the body weight, serum albumin, prealbumin, transferrin, blood lipid, serum total cholesterol, high density lipoprotein and low density lipoprotein before operation and on the fifth day after operation. To compare the indexes that the recovery time of intestinal function, the cost of nutritional support and the days of hospitalization between the groups. Reasults There was no significant difference in the index of nutrition, immunity and stress between two groups before operation (P>0.05). On the fifth day after operation, the levels of albumin, prealbumin and transferrin in the observation group were significantly higher than those in the control group (P<0.05), and the levels of blood lipids and LDL in the observation group were significantly lower than those in the control group (P<0.05). The recovery time of gastrointestinal function and hospitalization in the observation group were shorter than those in the control group (P<0.05), and the cost of nutrition was lower than those in the control group (P<0.05). Conclusions The application of Clinomel "all in one" standard parenteral nutrition in postoperative patients with rectal cancer nutritional support had good curative effect in the recovery period, which can improve the nutritional status, promote intestinal function recovery, reduce the degree of stress reaction, reduce hospitalization time and cost, get the good satisfaction of patients and medical staff.
2018 Vol. 5 (3): 269-273 [Abstract] ( 380 ) HTML PDF (967 KB)  ( 374 )
274 Analysis of related factors and nutritional status of patients with esophageal cancer at different perioperative periods
MA Xing-hao, YANG Hui, WANG Jia-jia, JIANG Xiao-yang, ZHANG Li, ZHANG Xu
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.011
Objective To investigate the nutritional status of esophageal cancer patients at different perioperative period and analyse the related factors malnutrition. Methods 60 patients with esophageal cancer were given early enteral nutrition support after operation. The nutritional status were evaluated by the patient-generated subjective global assessment (PG-SGA) before operation and the twelfth days after operation. Body mass index, arm circumference, arm muscle circumference, triceps skinfold thickness were monitored, and serum total protein, albumin and globulin, hemoglobin, total lymphocyte count, glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase were detected before operation, the seventh and twelfth days after operation. Compare the differences of each index in different periods and analyse the related factors of malnutrition before operation and the twelfth days after operation. Results PG-SGA scores before operation: 2 patients (3.3%) with good nutrition (PG-SGA 0~1), 11 patients (18.3%) with suspected malnutrition (PG-SGA 2~3), 31 patients (51.7%) with moderate malnutrition (PG-SGA 4~8), 16 patients (26.7%) with severe malnutrition (PG-SGA≥9) ; PG-SGA scores at the twelfth days after operation: 0 patients (0.0%) with good nutrition (PGSGA 0~1), 0 patients (0.0%) with suspected malnutrition (PG-SGA 2~3), 6 patients (10.0%) with moderate malnutrition (PG-SGA 4~8), 54 patients (90.0%)with severe malnutrition, and compared with before operation, the PG-SGA score increased significantly at the twelfth days after operation (P<0.01). Compared with preoperative values, serum total protein, albumin, hemoglobin and total lymphocyte count were significantly decreased (P<0.01), glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase increased significantly (P<0.01). Compared with the seventh days after operation, total protein and globulin increased significantly at the twelfth days after operation (P<0.05, P<0.01), and albumin had a rising trend, but there was no statistical significance (P>0.05). Compared with before operation, body mass index decreased, especially at the seventh days after operation, arm circumference and triceps skinfold thickness were decreased at the seventh and twelfth days after operation, especially at the twelfth days after operation (P<0.05); the PG-SGA scores before operation were negatively correlated with triceps skinfold thickness (P<0.01), and the PG-SGA scores at the twelfth days after operation were negatively correlated with arm muscle circumference and triceps skinfold thickness (P<0.05, P<0.01). Conclusions The presence of malnutrition in patients with esophageal cancer before and after operation, and the risk of malnutrition was increased after the operation. Early postoperative enteral nutrition support can gradually improve thenutritional index of patients, but to restore the preoperative level, the family nutrition support after discharge is essential.
2018 Vol. 5 (3): 274-278 [Abstract] ( 404 ) HTML PDF (2411 KB)  ( 348 )
279 Effect of continuous and intermittent enteral nutrition on nutritional status in patients with radiotherapy and chemotherapy
WANG Lu, SUN Ai-min
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.012
Objective To compare the nutritional status of patients undergoing chemoradiotherapy with continuous enteral nutrition therapy and intermittent enteral nutrition therapy. Methods 100 cases of radiotherapy and chemotherapy were randomly divided into the control group receiving intermittent enteral nutrition therapy and the observation group receiving continuous enteral nutrition therapy in the department of radiotherapy from June 2016 to June 2017. The effects of nutritional status in the two groups were compared. Results There were no significant difference in PG-SGA scores and biochemical indexes between the two groups before intervention, and the difference between the indexes after intervention was statistically signifcant (P<0.05), and the improvement effect of the observation group were better than those of the control group. Conclusions Compared with intermittent enteral nutrition therapy, continuous nutritional support was more helpful to improve the nutritional status of patients with chemotherapy and to improve the level of endurance of the body. It also helps to improve the immunity of the patients, thus shortening the time needed to restore the function of various tissues during the radiotherapy and chemotherapy cycle, to avoid and to reduce complications, to reduce the number of days in hospital, to save the cost for the patients and to avoid the middle end of the course due to malnutrition. It can be used as a clinical selection scheme.
2018 Vol. 5 (3): 279-282 [Abstract] ( 449 ) HTML PDF (1000 KB)  ( 336 )
283 Effects of all-in-one three-chamber bag parenteral nutrition solution on intestinal tumor patients’ nutritional and immune status after operation
YUAN Zhong-zhen, LIU Ling
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.013
Objective To observe the effects of industrial three-chamber bag “Clinomel” intravenous nutrition on improving the nutritional immunological indexes and shortening the length of postoperative hospital stay in patients after colorectal cancer radical surgery. Methods From January to August 2017, patients with radical resection of rectal cancer in the gastrointestinal surgery affiliated to the Affiliated Cancer Hospital of Chongqing University were selected. According to the exclusion criteria, 80 patients were selected as the objects of the study. There were 41 cases in the Clinomel group and 39 in the control group. The differences in average age, weight, and body mass index between the two groups had no statistical significance (P>0.05), and the materials had good comparability. The changes of nutritional immunological indexes in the two groups were analyzed and the length of postoperative hospital stay was compared between the two groups. Results There were no significant differences between the two groups of albumin、prealbumin and globulin both pre-operation and the first day after operation (P>0.05); but the differences of albumin, prealbumin and globulin in 7 days after operation were statistically significant (P<0.05); the length of postoperative hospital stay of the Clinomel group was shorter than the control group, the difference was statistically significant (P<0.05). Conclusions Reasonable application of “Clinomel” for parenteral nutritional support therapy was beneficial to improve the nutritional status after radical operation of colorectal cancer, shorten postoperative hospital stay and improve the quality of life of patients.
2018 Vol. 5 (3): 283-286 [Abstract] ( 308 ) HTML PDF (950 KB)  ( 406 )
287 Effect of fluid on preoperative bowel preparation combined with narrative nursing for gynecologic laparoscopy
1SHI Jun-hui, 2KONG Yu-xian
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.014
Objective To investigate the feasibility and clinical effect of using narrative nursing method to guide patients to prepare bowel preparation before gynecologic laparoscopic surgery. Methods A retrospective study was conducted to observe the effect of preoperative intestinal preparation in patients undergoing laparoscopic surgery by laparoscopic total hysterectomy in July 2017 to March 2017 in our hospital, which were divided into the application of narrative therapy(study group) and the non applied narrative therapy enteral nutritional support (control group). The satisfaction of the two groups of surgeons for bowel preparation of the two groups of patients, postoperative exhaust time and length of stay were statistically different. Results The satisfaction of the surgeons to the bowel preparation of the patients in the study group was 90%, and the satisfaction of the intestinal preparation in the control group was 64%, and the difference was statistically significant (P<0.01). The satisfaction of bowel preparation in the study group was statistically significant compared with that in the control group (P<0.05). The exhaust time and hospitalization time in the study group were significantly lower than those in the control group (P<0.05). Conclusions It is safe and effective to tell the patients who need surgery by narrative method of oral enteral nutrition, to reduce the psychological pressure of the patients, to complete the perioperative nursing, and to improve the satisfaction of the surgeons in the operation, and to accelerate the recovery time of the patients after operation. In the course of communication with the patients, the nursing staff increased the degree of respect to the patients, further stimulated the enthusiasm of the nursing staff to learn the specialized knowledge, and improved the quality of nursing.
2018 Vol. 5 (3): 287-291 [Abstract] ( 298 ) HTML PDF (1015 KB)  ( 295 )
292 Expression of targeting protein for TPX2 in bladder cancer and its clinical significance
1YAN Xin, 1GUO Zi-xin, 1YUAN Jia-yi, 1FENG Yu-jia, 1LI Jie-li, 2, 3LI Sheng
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.015
Objective To clarify the connection between TPX2 expression and clinicopathological characteristics of bladder cancer, so as to evaluate the function of TPX2 as a prognosis marker in bladder cancer. Methods GEO datasets were collected and expression profile and clinical information were analyzed. GSEA was conducted to explore the gene sets enriched in TPX2 high-expression samples. Results The expression of TPX2 was up-regulated in bladder cancer (P<0.0001); TPX2 expression was significantly associated with age, sex, T stage, N stage, progression, grade. Higher expression of TPX2 indicated poor prognosis in bladder cancer. GSEA indicated that TPX2 regulates gene sets associated with spermatogenesis,unfolded protein response, PI3K/ AKT/mTOR signaling,mTORC1 signaling, cholesterol homeostasis, mitotic spindle, glycolysis, G2M checkpoint, E2Ftargets, myctargets. Conclusions TPX2 is highly expressed in multiple tumors and functions as potential marker and target in diagnosis and treatment in bladder cancer.
2018 Vol. 5 (3): 292-296 [Abstract] ( 346 ) HTML PDF (1218 KB)  ( 301 )
297 The effects of goal-directed nutrition therapy model on nutritional status and postoperative rehabilitation in gastric cancer patients
TANG Xiao-li, ZHANG Ting, WANG Guo-rong, XU Rui, WANG Jing, LI Yin-feng, LV Jia-hua
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.016
Objective To explore the effect of goal-directed nutrition therapy model on the nutritional status and postoperative rehabilitation of gastric cancer patients (total gastrectomy) from admission to discharge. Methods A cancer target nutrition team was established and the quality control standards for nutrition implementation was also developed. 82 gastric cancer patients from February 2017 to July 2017 were included in the control group, and 89 gastric cancer patients from August 2017 to January 2018 were included in the experimental group. Standardized nutrition assessment and malnutrition level 3 diagnosis was performed in experimental group. According to the patient’s condition, we chose the goal-directed nutrition therapy and a reasonable nutritional preparation; Meanwhile, target nutrition was performed in the period of pre-operative, post-operative, rehabilitation and postdischarge. We also need to regularly evaluate the efficacy of enteral nutrition and constantly adjust the target nutrition. In addition, some data on admission and discharge should be compared between the two groups, such as changes in body weight, albumin, hemoglobin, and prealbumin, the first anal exhaust time, average hospital stay and postoperative complications. Results Compared with the control group, the difference in the first anal exhaust time (t=2.101, P=0.039) and in the average hospitalization time (z=-2.081, P=0.037) was statistically significant. The difference in body weight between discharge and admission (t=-5.433, P<0.01) and prealbumin at 3 months after discharge (t=2.561, P=0.014) was statistically significant. In addition, there were no significant differences in the changes of albumin, hemoglobin and lymphocyte counts (P>0.05). The number of postoperative complications were 6 and 16, respectively, and the difference was statistically significant (χ2=6.209, P=0.013). Conclusions The team of goaldirected nutrition therapy model is a feasible nutrition management model for cancer patients, which can improve the nutritional status of patients, accelerate the recovery of postoperative patients, and improve patient comfort and satisfaction.
2018 Vol. 5 (3): 297-302 [Abstract] ( 425 ) HTML PDF (1093 KB)  ( 338 )
303 Qualitative research on oral nutritional supplements experience in patients with postoperative adjuvant chemotherapy of gastrointestinal tumors
ZHAO Si-yu, ZHANG An-qin,YE Xiang-hong
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.017
Objective Under the background that oral nutrition supplement is widely used in the nutritional treatment of patients with gastrointestinal malignancies, we acquired the understanding and feeling of the patients with gastrointestinal tumors after surgery and receiving oral nutrition powder after adjuvant chemotherapy. To provide the basis for clinical guidance, improve the patient compliancel, ensure the therapeutic effect of nutritional support. Method The purpose sampling method and the stratified purposive sampling strategy are adopted. A total of 14 patients with gastric and intestinal tumors in a tertiary-level hospital from November 2017 to April 2018 were investigated. They were all have received oral nutritional supplements After the operation. 14 patients received semistructured in-depth interviews, and the interview data was analyzed and sorted out by Nvivo11 software. Result 3 subjects were extracted from the analysis including the attitude towards nutritional powder, the problems of taking nutritional powder, and the attention to health information. Most patients lack adequate awareness about oral nutrition supplement, and only 21% of them hold a positive attitude towards it after taking oral nutrition supplement. special needs of patients with comorbidities, do not understand the method and discomfort experience are patients ‘ problems; Half of patients passively pay attention to health information. Patients who are actively followed by the Internet and consultation with medical staff. Conclusions Patients’ experience of oral nutrition supplement is multifaceted, and the problems reflected are not optimistic. By taking medical care of integration cooperation pattern, improve health education process, focusing on the symptom management while in hospital and the continual care at home, promoting more flavor formula nutrition powder and strengthening the supervision of network health information,the clinical outcomeand the life quality can be improved.
2018 Vol. 5 (3): 303-307 [Abstract] ( 377 ) HTML PDF (954 KB)  ( 410 )
308 Quantum medicine and modernization of traditional Chinese medicine
1RAO Ben-qiang, 2JIN Shuai
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.018
Quantum medicine is an emerging discipline that combines physics, mechanics, mathematics, statistics, and modern biomedical sciences. It has achieved some breakthroughs in the fields of disease prevention, early diagnosis, treatment, and drug development, and has shown unique advantages. Quantum nonlocality and Bell’s theorem are the theoretical basis and essential features of quantum medicine. Quantum entanglement, quantum guidance and Bell nonlocality are the three main forms of interaction between organisms and external factors, and the analysis, calculation and detection of biological quantum information are the basic methods of studying quantum medicine. Quantum is the smallest basic unit of physics. Quantum medicine, which reflects the quantum changes of living organisms, is highly sensitive to the occurrence and development of human diseases, and is conducive to the early diagnosis and early treatment of human diseases (such as quantum detection of solid tumor accuracy rate of 93.37% and blood tumor accuracy rate is 88.75%) and is suitable for early warning of sub-health status, research on substance and energy metabolism mechanism and drug development. The nonlocality of quantum medicine gives this emerging medicine a “holistic view” and “dialectical treatment” characteristics, which is compatible with traditional Chinese medicine. It clarifies some basic theories of traditional Chinese medicine and clarifies the effect components and effects of traditional Chinese medicine compound. The mechanism has important value and can promote the modernization process of Chinese medicine. Quantum medicine is still in its infancy, especially the complexity of quantum information detection methods restricts the application and development of quantum medicine. With the continuous development of quantum physics theory, quantum mechanics and modern medicine, more high-quality study based on quantum medicine, biological quantum information detection and application are needed.
2018 Vol. 5 (3): 308-312 [Abstract] ( 367 ) HTML PDF (1228 KB)  ( 868 )
313 Research advances of TKTL - 1 in malignant tumor
1JIAN Mei-cheng, 1XU Jia-xi, 2ZHANG Jie, 3SHI Han-ping, 4MIAO Ming-yong
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.019
TKTL-1 is a member of human TKT gene family, and the genes of the TKT family consist of TKT, TKTL-1 and TKTL-2. In human body, pentose phosphate pathway contains two pathways: oxidation pathway and non-oxidation pathway, TKT plays a key role in non-oxidative pathway. It catalyzes the conversion of ketose into aldose in the body. After a series of reactions, it continuously generates 5-phosphorylated ribose and NAPDH which are the raw materials of antioxidant response and biosynthesis. The current study suggests that there is a close relationship between TKTL-1 and the occurrence, development and metastasis of tumors. Some studies found that TKTL-1 has a different activity from other TKTs and shows high expression in many tumors, while the expressions of TKT and TKTL-2 in malignant tumors have no obvious regularity or just small changes. In this paper, we divide the role of TKTL-1 in malignant tumors into four aspects. First and foremost, TKTL-1 can provide raw materials for tumors, work in coordination with the reprogramming of cancer metabolism and provide a material basis for the proliferation and metastasis of malignant tumors. In addition, the high expression of TKTL-1 can promote the metastasis of tumor to peripheral lymph nodes. What’s more, TKTL-1 is closely related to the immunosuppression and drug resistance of the tumor: it produces lactic acid by glycolysis, inhibiting the immune monitoring of T cells and NK cells; and the inhibition of oxygen free radical production by lactic acid will reduce the antitumor effect of sorafenib and other drugs. At present, numerous studies have shown that TKTL-1 is a potential tumor marker which has great significance on the diagnosis and prognosis of tumors. In terms of treatment, studies have shown that the TKTL-1 inhibitors can inhibit tumor growth and metastasis, so TKTL-1 may be a potential biotherapeutic target. Co-treatment of TKTL-1 inhibitors with other metabolic modulation therapies may further enhance the anti-tumor efficacy of TKTL-1.
2018 Vol. 5 (3): 313-319 [Abstract] ( 469 ) HTML PDF (1151 KB)  ( 425 )
320 Treatment of cancer-related anemia
1LI Yu-ying, 2FANG Yu, 1LI Wei
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.020
Cancer-related anemia (CRA) is a kind of anemia caused by tumor-associated inflammation or tumor-related treatment that leads to myelosuppression (mainly radiotherapy and chemotherapy). Its frequency and severity depend on tumor type, tumor stage, duration of disease, and treatment status. The incidence of cancer-related anemia in China is 60.83% of which mild anemia 40.84%, moderate anemia 15.67%, severe anemia 3.47%, extremely severe anemia 0.84%. The higher morbidity of the tumor is gastrointestinal cancer, breast cancer and lung cancer. Cancer-related anemia adversely affects quality of life and is associated with reduced overall survival. The correction of anemia in cancer patients has the potential to improve treatment efficacy and increase survival. The pathogenesis of cancer-related anemia is multifactorial, and can be a direct result of cancer invasion (blood loss, marrow infiltration, hemolytic anemia, inflammation), or its treatment (radiotherapy and chemotherapy). Treatment should correct etiologic factors, whenever possible. Symptomatic treatments are red blood cell transfusions, administration of erythropoiesis-stimulating agents and materials for hematopoiesis (iron, folic acid and Vitamin B12).
2018 Vol. 5 (3): 320-323 [Abstract] ( 316 ) HTML PDF (947 KB)  ( 352 )
324 Progress in the relationship between muscle reduction and metabolic syndrome
1QI Shu-jing, 1QI Rui-xia, 2ZHANG Wu-lin, 1ZHANG Jin-feng, 1SUN Yu-hang, 3KANG Yan-hui, 1LI Wei, 1FU Ze-xian, 1YANG Fu-shen, 1HUO Zhong-chao, 1LU Jia-hui, 1YU Xiao-juan, 1ZHANG Bao-xia, 1REN Yong, 1ZH
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.021
Sarcopenia is a progressive, systemic syndrome, which is an age-related disease, mainly manifests in the reduction of skeletal muscle mass, decreased muscle strength and function. Skeletal muscle is not only the movement system of human body, but also the body metabolism organ, which involves in the secretion and metabolism of the body, such as glucose, glycogen and lipid metabolism, secreting a variety of cytokines, etc. Metabolic syndrome is a group of clinical syndromes with multiple metabolic disease are mainly characterized by obesity, abnormal glucose metabolism or diabetes, hypertension and dyslipidemia. Due to physical activity levels falling and metabolism ability decreasing, the chance of muscle reduce disease has greatly increased in elder people, leading to metabolic diseases such as high cholesterol, high blood pressure, diabetes and other diseases of the elderly. The two diseases are both closely related to the declining ability of the human body aging, metabolism, and belong to age-related diseases. Because the metabolic syndrome is not a single disease, the research of the relationship between metabolic syndrome and reduce muscle diseases is truly studying the relationship between the related disease and reduce muscle disease. This article will interpret the relationship between the two diseases from both the common pathological basis and metabolic abnormality aspects.
2018 Vol. 5 (3): 324-327 [Abstract] ( 463 ) HTML PDF (967 KB)  ( 615 )
328 Hepatic steatosis cause by chemotherapy have an influence on therapy of hepatic metastasis of colorectal carcinoma
ZAN Ying, DAI Zhi-jun, WANG Bao-feng, CUI Ying-tao, LU Xiao-lan
DOI: 10.16689/j.cnki.cn11-9349/r.2018.03.022
Context colorectal cancer is the third most common form of cancer and the fifth most frequent cause of cancer deaths in China and has a tendency to increase year by year. Primary treatment of advanced colorectal cancer still is chemotherapy, and chemotherapy can cause non-alcoholic hepatic steatosis. Hepatic metastasis is the most common metastatic pathway in colorectal cancer patients, and about 50% of colorectal cancer will eventually develop hepatic metastasis, among which colon cancer combined hepatic metastasis is about 15% to 25%, while others are metachronous liver metastases. The incidence of hepatic metastasis is higher in colorectal cancer with hepatic steatosis, but there is also evidence that hepatic steatosis which can reduce the incidence of liver metastasis. Chemotherapy and target therapy for colorectal cancer are commonly used in past studies have found that cause the hepatic steatosis, and the hepatic steatosis increased with the increase of chemotherapy time and period. Prevent therapy with cholestasis or enzymatic drugs can improve the liver function injury. If have hepatic steatosis, the postoperative residual liver volume increased, and due to the change of liver texture, the risk of intraoperative hemorrhage increased significantly and the difficulty of hemostasis increased, leading to a significant increase in the risk of surgery. Study hepatic steatosis cause by chemotherapy have an influence on therapy of hepatic metastasis of colorectal carcinoma has very realistic clinical significance.
2018 Vol. 5 (3): 328-332 [Abstract] ( 356 ) HTML PDF (1398 KB)  ( 415 )
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