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2019 Vol. 6, No. 1
Published: 2019-05-10
 
1 Low-carbohydrate diet Hot!
1 SHI Han-ping, 1 YU Kai-ying, 2 ZHOU Hu
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.001
 Hyperinsulinemia and insulin resistance are the common underlying physiopathological mechanisms for chronic metabolic disorders. Both overweight and obesity lay the foundation for the etiology of chronic metabolic disorders. The carbohydrate-insulin model indicates a high carbohydrate intake rises blood glucose level and promotes insulin secretion. Energy is stored as fat in adipose tissue under the direction of insulin. Consequently, the oxidation by metabolically active tissues is suppressed which leads to a cellular starvation state. In response, hunger and appetite are elevated and that results in an increased body weight. Restricting the dietary carbohydrate to 150g/d or below, or <26% of the total daily energy intake, decreases the insulinsecretion, and it could change how the body utilizes energy to promote the oxidation of fat. The alteration may lead to a decreased body weight due to the loss of fat mass. The low-carbohydrate diet puts no restriction on total energy and protein intake; therefore, it has better compliance comparing with other dietary interventions. The short-term efficacy of low-carbohydrate diets is evident in previous literature since it has fewer adverse health effects than drugs, and it is also cost-efficient regrading health economics. The low-carbohydrate diet is viewed as the first approach for managing chronic metabolic disorders including obesity, type 2 diabetes,NAFLD, and metabolic syndrome. Therefore, the research into low-carbohydrate diets is of great importance. However, low-carbohydrate diets should not be employed as an everyday diet under normal physiological state, and further research on its long-term effect is warranted.
2019 Vol. 6 (1): 1-6 [Abstract] ( 736 ) HTML PDF (1882 KB)  ( 1337 )
7 Food and drug interactions: a general review
1REN Xia-yang, 2CONG Ming-hua
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.002

Drugs will be affected by various factors in the body, with the increasing of human food varieties and the diversity of dietary structure, food has increasingly become a factor that can not be ignored, especially oral drugs. It may occur in the astrointestinal tube firstly by various physical and chemical reactions, and then affect the PK and PD of the drug, leading to changes in drug treatment outcoming. Equally, drugs may also affect the appetite and the absorption and utilization of the food and nutrients, leading to nutrient disorder or imbalance. Now people take more attention on this area. This paper introduces the classification and occurrencing lacation of the interaction between food and drug, some food, especially grapefruit juice and some other fruit juice, affecting the inhibitory pathway of the CYP3A enzyme system on the drug metabolism, and the effect of the drug on the absorption, metabolism and excretion of food, and the common interaction of oral antitumor drugs and food and the cautions for use . Clinical medical staff and pharmacists should understand and master the basic knowledge and common examples of food and drug interactions, educate patients about rational use of drugs, avoiding taking interacting foods, which could reduce the drug induced damage or treatment failure due to improper diet and achieve the optimal treatment effect.
2019 Vol. 6 (1): 7-12 [Abstract] ( 493 ) HTML PDF (1050 KB)  ( 826 )
13 Research progress in clinical diagnosis and treatment of frailty
LIU Jie, XU Hong-xia
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.003
A cluster of symptoms including falls, disability, cognitive impairment, decreased autonomic activity, unwilled weight loss and fatigue are common in older people, and together this “core symptom complex” defines frailty. Frailty is often related to malnutrition, but is distinguished by the presence of sarcopenia. Frailty embodies the decline in a patient’s overall function, which is not entirely explained by a loss of skeletal muscle mass or decreases in muscle function. Frailty occurs when the individual’s physiological reserve decreases in conjunction with internal dynamic balance disorders and physiological debility. Frailty is associated with adverse clinical outcomes including an increased risk of complications of other conditions and surgery, unintentional injury (falls and fractures), disability, a poor quality of life, and even death. Frailty is common not only in the elderly, but also in patients with cancer, cardiovascular diseases, respiratory diseases, and malnutrition. The prevalence of frailty has been reported to be between 4.0%~59.1% in different reports, and increases with age. Frailty can be diagnosed by the presence of the core symptom complex (frailty phenotype) or based on the frailty index (FI). Early assessment and treatment can significantly improve the health prognosis of patients. Treatments aimed at maintaining an individual's homeostasis can be more beneficial to preventing or resolving frailty than treating the underlying disease alone. Improving the patient’s nutritional status, implementing physical exercise, and developing individualized multidisciplinary interventions may be the best ways to prevent adverse clinical outcomes in patients with frailty. This article reviews the definitions, diagnosis, epidemiology, etiology and pathogenesis of frailty, as well as the interventions that can be used to combat frailty.
2019 Vol. 6 (1): 13-20 [Abstract] ( 480 ) HTML PDF (1096 KB)  ( 627 )
21 Metabolic characteristics and nutrition therapy for patients with cancer pain
BAI Ri-lan, CUI Jiu-wei
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.004
Cancer pain refers to tumor, tumor-related symptoms or the pain caused by anti-tumor treatment, and that the occurrence and development of cancer pain are closely related to the nutritional metabolism of the body. Cancer pain affects the body's nutritional metabolism through dietary intake, neuroendocrine system, social psychosocial and so on. In turn, the changes in the body's various nutrients, including vitamins, magnesium and caffeine, curcumin, capsaicin, polyunsaturated fatty acid (PUFA), etc. also have certainly impacts on cancer pain through multiple mechanisms. In addition, abnormal metabolisms of tumor cells are involved in the genesis and development of cancer pain.Among them, the increase of glutamate content is mainly due to the imbalance of oxidation-reduction system in tumor cells and the increase  metabolic level of glutamine (Gln) , and then glutamate promotes persistent transmission of nociceptive signals though mediating transient receptor potential cation channel subfamily V member 1 (TRPV1). This article mainly reviews the interaction between cancer pain and nutrient metabolism, as well as mechanisms related to tumor metabolites causing cancer pain, finally proposes nutrition therapy for patients with cancer pain.
2019 Vol. 6 (1): 21-25 [Abstract] ( 504 ) HTML PDF (1398 KB)  ( 441 )
26 Sarcopenia and nutrition
1,2,3SU Lin, 4LIU Shuang, 1,2,3DONG Bi-rong
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.005
 Abstract: Sarcopenia is a syndrome of age-related progressive and universal reduction and loss of skeletal muscle mass and strength. Sarcopenia is very common in older adults, with approximately 10% of old people aged 60 and above suffering from this syndrome. The risk of clinical adverse events such as disability, quality of life, and death is greatly increased in older adults with sarcopenia. Malnutrition is also a common problem in the old age population. Although older adults with normal nutritional status may also suffer from sarcopenia, studies found that the risk of sarcopenia is further increased in malnourished older adults. In addition, the lack of certain micronutrients has also been found to be associated with the onset of sarcopenia. Given the adverse effects of sarcopenia on the outcome of older adults, more and more researcher are beginning to explore effective interventions for sarcopenia. At present, the interventions for sarcopenia mainly start from the etiology, including exercise intervention, nutrition intervention, hormone supplementation and drug intervention. Nutrient intervention has become a hot topic in recent years. Nutritional interventions for sarcopenia are diverse, including proteins, amino acids, creatine, vitamin D, minerals, and unsaturated fatty acids. This article will review the effectiveness of different nutritional interventions of sarcopenia, and based on the current evidence to propose recommendations for nutritional intervention of sarcopenia.
2019 Vol. 6 (1): 26-34 [Abstract] ( 501 ) HTML PDF (1115 KB)  ( 614 )
35 The standards for good nutrition therapy ward for cancer patients
LI Su-yi, ZHANG Xiao-tian, CONG Ming-hua, XU Hong-xia, LUAN Chun-na, GAO Jin, HUANG He, SUN Ling-yu, SUN Yuan-shui, WANG Chang, WANG Kun-hua, GUO Zeng-qing, LI Tao, GUAN Wen-xian, CUI Jiu-wei, LU Qian
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.006
 Abstract: Malnutrition is frequently present among cancer patients, which diminishes treatment efficacy while increasing therapeutic side effects. Therefore, it is essential to set standards for National Good Nutrition Therapy Ward (GNT Ward) to regulate the nutritional care practice in a clinical setting. Cancer nutrition therapy (CNT), developed based on oncology and nutrition theory, aims to treat cancer and its complications, enhance physical conditions, and improve the prognosis via nutritional interventions. CNT consists of 3 stages, including nutritional diagnosis, nutritional intervention, and efficacy evaluation. A GNT Ward title is granted to a ward, a department, and/or a hospital, who performs the standardized CNT. These units showcase CNT in practice and provide guidance to their counterparts. Grade III comprehensive hospitals, capable Grade II comprehensive hospitals, and all cancer specialized hospitals are encouraged to establish a GNT Ward. The establishment of the GMT Ward is of great significance on a national scale regarding preventing and/or treating cancer-related malnutrition, improving cancer therapy efficacy, securing the health care safety for patients, ameliorating the quality of life, extending the survival time, and saving medical costs.
2019 Vol. 6 (1): 35-40 [Abstract] ( 619 ) HTML PDF (1605 KB)  ( 691 )
41 Association of miR-205 expression with clinical pathology and prognosis of renal carcinoma
LI Shi-jun, XIANG Kui
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.007
 Abstract: Objective Renal cell carcinoma is induced by a variety of factors. The expression of miR-205 in renal cell carcinoma and renal cell carcinoma was studied. The relationship between the clinicopathological characteristics and prognosis of patients with renal cell carcinoma and the expression of miR-205, and the mechanism of miR-205 were elucidated. Methods From February 2010 to February 2014, 60 cases of renal carcinoma tissue and normal tissue samples were selected from the Department of Urology at our hospital. Expression level of miR-205 was detected by RT-PCR analysis. We observed the function of miR-205 on biological behavior of ACHN cells in vitro, the ACHN cell was transfected with miR-205 to up-regulate miR-205 expression. MTT was used for evaluating cell proliferation in miR-205 up-expression. Transwell assays were employed for investigating the cell invasion and migration ability inmiR-205up-expression. Immunohistochemical was used to investigate the Epithelial mesenchymal transformation in ACHN cell. Results The expression of miR-205 was detected in renal carcinoma tissues and normal renal tissues, but the renal carcinoma tissues showed a significantly lower expression. The expression of miR-205 was correlated with infiltration and relapse of renal carcinoma (P<0.05), but showed no correlation with pathological stage or clinical stage of renal carcinoma (P<0.05). After mir-205 overexpression, it was found that the growth of renal cancer cells was significantly inhibited (P<0.05), and the migration efficiency was significantly reduced (P<0.05). There is epithelial mesenchymal transformation in renal carcinoma cells, and mir205 may inhibit cell proliferation and migration by inhibiting epithelial mesenchymal transformation. Conclusions The decreased expression of miR-205 were correlated with the progress of renal carcinoma. This result may provide new ideas for studying the molecular mechanism of renal carcinoma and develop a new therapeutic strategy for renal carcinoma in the future.
2019 Vol. 6 (1): 41-46 [Abstract] ( 376 ) HTML PDF (2126 KB)  ( 324 )
47 Antitumor experimental study on compound of phytochemicals
1ZHU He-cheng, 1YANG Sheng, 2ZHU Bin, 1XU Yang, 1YAO Yi, 1LI Wang, 1TANG Da-han, 1HUANG Ya-jing, 1LUO Yi, 2REN Cai-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.008
 Objective  The study aims in investigating anti-tumor activity of ginsenoside, resveratrol, ganoderma polysaccharides and cordyceps sinensis in human cancer cell lines, and whether the combination of all four phytochemicals (GRGC) exerts synergistic anti-tumor effect. Methods  Human cancer cell lines (A549, MCF-7 and SW480) were treated with single formulation of Ginsenoside, Resveratrol, Ganoderma polysaccharides or Cordyceps sinensis, or the combined GRGC. All treated cells were analyzed for proliferation by CCK8 assay. Analysis of cell cycle arrest and apoptosis were conducted in cells treated with combined GRGC by flowcytometry. Furthermore, the ultrastraccture of A549 cells treated with GRGC was investigated by transmission electron microscope. Results  Ginsenoside, resveratrol, ganoderma polysaccharides and cordyceps sinensis exerted dose-dependent inhibition of proliferation in A549, MCF-7 and SW480 cells, while the mixed GRGC demonstrated significant synergistic effect in antitumor activity. After treatment with the GRGC, A549, MCF-7 and SW480 cells were arrested in the G0/G1 phase. Flowcytometry analysis revealed that the mixture of GRGC could induce apoptosis in A549, MCF-7 and SW480 cells in a dose-dependent manner. Electronphotomicrograph of GRGC treated A549 tumor cells showed that the cell membrane and nuclear envelope were broken, the nucleus concentrated and aggregated along the border, indicating massive or crescent like apoptosis. Conclusions  The mixture of the four phytochemicals GRGC exhibits significant synergy in inhibitory activities against tumor cells (A549、MCF-7、SW480), induces cell cycle arrest in the G0/G1 phase to inhibit tumor cell proliferation and to induce apoptosis of tumor cells (A549、MCF7、SW480). The combination of all four phytochemicals (GRGC) have obvious synergistic anticancer effect, which provides a solid foundation for the comprehensive treatment of cancer.
2019 Vol. 6 (1): 47-52 [Abstract] ( 389 ) HTML PDF (2375 KB)  ( 319 )
53 Application of “single-incision plus one” combined with ERAS for upper rectal and sigmoid colon cancer
1TENG Wen-hao, 1WEI Cheng, 2JIANG Wen-wen, 1XIAO Jun, 1ZANG Wei-dong
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.009
 Objective  To evaluate the efficacy of single-incision plus one port laparoscopic surgery (SILS+1) combined with enhanced recovery after surgery (ERAS) for upper rectal and sigmoid colon cancer. Methods  A retrospective analysis on 92 cases of upper rectal and sigmoid colon cancer patients who were undergone enhanced recovery after surgery was performed. According to the different operation methods, they were divided into two groups, SILS+1 combined with ERAS group (39 patients) and conventional laparoscopic surgery (CLS) combined with ERAS group (53 patients). Then the perioperative data would be compared. Results  The two groups were well balanced with respect to the baseline characteristics (P>0.05). There were no significant difference in operating time, bleeding, resection margin, number of retrieved lymph nodes and morbidity (P>0.05). However, as compared to the CLSERAS group, patients in SILS+1-ERAS group had a smaller incision [(6.7±1.1)cm vs.(8.5±1.3)cm, P=0.000], shorter time to first ambulation [(22.2±5.2)h vs. (27.1±7.9)h, P=0.001], shorter time of bowel movement [(70.2±19.8)h vs. (83.1±20.4)h, P=0.005], lower C-reaction protein in the first day [(43.5±28.6)mg/L vs. (57.2±33.2)mg/L, P=0.038] and shorter time of postoperative hospital stay [(7.0±1.7)d vs. (8.1±2.1)d, P=0.010]. Moreover, the visual analogue scale (VAS) scores were lower from 2 to 4 days after operation in SILS+1-ERAS group (P<0.05). Conclusions  For experienced laparoscopic surgeons, it is safe and reproducible in single-incision plus one port laparoscopic surgery combined with ERAS for upper rectal and sigmoid colon cancer. The technical of SILS+1 could reduce the difficulty of operation and postoperative pain, promote postoperative rehabilitation. So it is worthy of clinical promotion.
2019 Vol. 6 (1): 53-57 [Abstract] ( 404 ) HTML PDF (1537 KB)  ( 379 )
58 Influence of CYP4502E1 gene polymorphism on chemotherapeutic efficacy of recurrent breast cancer
1JIN Zhi-guo,?2ZENG Hui-jun
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.010
 Objective  To investigate the association between cytochrome P4502E1 polymorphism and clinical outcomes in recurrent breast cancer patients treated by docetaxel plus capecitabine. Methods  Seventy recurrent breast cancer patients who were treated with docetaxel plus capecitabine were included in this study. Meanwhile, the correlation between single nucleotide polymorphisms (SNP) sites at rs2070673 of CYP4502E1 alleles and treatment response rate and prognosis were analyzed. Results  Compared with wild homozygote (AA genotype) of P4502E1 gene, heterozygote (AT genotype) reduced disease progression risk by 73% (OR=0.27, 95% CI=0.05~1.41), and mutated homozygote (TT genotype) reduced disease progression risk by 88% (OR=0.12, 95% CI=0.02~0.71). The median OS with AA and AT genotype was 20.7 months (95% CI=17.0~24.4), but the median OS of TT genotype was significantly longer 28.5 months (95% CI=17.0~40.0). There were statistically significant differences (P<0.05). Conclusion  For patients with recurrent breast cancer, cytochrome P4502E1 gene is a polymorphic site that can affect the efficacy of first-line chemotherapy with docetaxel plus capecitabine. TT genotype patients have lower recurrence risk and significant advantage in survival. The P4502E1 gene is a polymorphic site that can affect the survival of patients with recurrent breast cancer treated by docetaxel plus capecitabine.
2019 Vol. 6 (1): 58-61 [Abstract] ( 406 ) HTML PDF (1871 KB)  ( 304 )
62 Comparison of effects of propofol target controlled infusion combined with dexamethymidine on anesthesia in tumor patients
JIANG Jing-wen, SHENG Wei-xuan, LIU Peng-fei, GUAN Lei
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.011
 Objective  Compared with the effects of Dexmedetomidine on the induction of anaesthesia using Marsh and Schnider models of propofol Target-controlled Infusion. Methods  60 patients with colorectal cancer scheduled for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy under general anesthesia were randomly divided into 2 groups: Marsh group (group M, n=30) and Schnider group (group S, n=30). All the patients received 0.8 µg/kg loading dose of dexmedetomidine, followed by TCI anaesthesia with remifentanil at 2 ng/mL. After the effect-site concentration of remifentanil reached 2 ng/mL, propofol TCI induction was started. Anaesthesia induction commenced in the Marsh group at a target plasma concentration of 2 µg/mL, whereas it started in the Schnider group at a target effect-site concentration of 2 µg/mL. If induction was delayed after 3 min, the target concentration was gradually increased to 0.5 µg/mL every 30 sec until successful induction. The Ct at successful induction, Ce at successful induction, induction time, and haemodynamic parameters were recorded. Results  The requirement of Ct for successful induction by Schnider model was significantly lower than that of Marsh model (3.43±0.22 VS 4.06±0.29μg/ml; P=0.05). Compared with Marsh model, the induction time of Schnider model was shorter (128.3±5.31 vs 160.7±3.30; P=0.01), and there was no significant change in hemodynamic parameters after successful induction. Conclusions  In the inter-group comparison, dexmedetomidine reduced the Ct concentration required for induction of Schnider model and shortened the induction time.
2019 Vol. 6 (1): 62-65 [Abstract] ( 398 ) HTML PDF (1070 KB)  ( 291 )
66 Effects of nutrition and chemotherapy on serum trace elements and immune function in cancer patients
1LIN Yun, 1CHEN Zhi-gang, 2CAO Yang, 3WAN Shan, 1TANG Qiu
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.012
Objective  To investigate the changes of serum trace elements and immune function in patients with cancer after chemotherapy, and investigate the effect of enteral nutrition on those as well. Methods  Between March and May of 2018, 19 cancer patients, aged 18~70 years, with KPS score equals or more than 60, were enrolled and randomly divided into two groups. One of them with 9 subjects received enteral nutrition intervention during chemotherapy; another group with 10 subjects received chemotherapy only without enteral nutrition intervention. Serum trace elements and peripheral blood lymphocyte subsets were measured before and after chemotherapy. A paired t-test with two-tailed was used to compare two population means by SPSS 18.00,  and the significant difference between two groups was considered when P<0.05. Results  The serum manganese concentration in patients without nutritional intervention after chemotherapy was significantly lower than that before chemotherapy (P=0.004), the serum lead was borderline lower after chemotherapy compared with that before chemotherapy (P=0.057); the serum zinc content in patients with nutritional intervention after chemotherapy was significantly lower than that before chemotherapy, and the NK cell percentage in peripheral blood was borderline decreased in patients with nutritional intervention after chemotherapy compared with that before chemotherapy, while the ratio of CD4+/CD8+ was borderline increased after chemotherapy compared with that before chemotherapy (P=0.057). Conclusion  Chemotherapy and nutrition intervention have certain effects on the concentration of serum trace elements, nutrition intervention has borderline influence on the distribution of peripheral blood T cells, which shows that the proportion of NK cells was borderline decreased after chemotherapy and the ratio of CD4+/CD8+ was borderline increased after chemotherapy. Because the number of cases is limited and the duration of nutrition intervention is short, it is necessary to increase the number of cases and prolong the time of nutrition intervention.
2019 Vol. 6 (1): 66-69 [Abstract] ( 448 ) HTML PDF (1075 KB)  ( 343 )
70 Correlation study between self-efficacy and perceived social support in patients with esophageal cancer undergoing radiotherapy and chemotherapy
LIU Gui-fang
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.013
 Objective  To explore the correlation of self-efficacy and perceived social support status of patients with esophageal cancer during the concurrent chemoradiation. Methods  216 subjects with esophageal cancer were selected as study populations in department of stomatology, Beijing rehabilitation hospital affiliated to capital medical university. Apply the general self-efficacy scale, understanding social support scale, and general information questionnaire investigation to evaluate. Results Patients with esophageal cancer during the concurrent chemoradiation self-efficacy overall score was (25.94±5.28). The age is greater, monthly income >5000 yuan, have health care, diagnosis duration is 6 to 10 years, has a history of treatment of patients with higher self-efficacy level (P<0.05). The score of perceived social support was (61.67±10.86), in the family support was (23.46±3.91) and family support was (38.09±8.90) points; The age is greater, ethnic minorities, higher level cultural, live in cities, professional for medical staff, monthly income >5000 yuan, have health insurance, diagnosis duration is less than 6 years have the higher level for understanding social support (P<0.05). Patients self-efficacy and perceived social support and each dimension has significantly positive correlation (P<0.01). In addition, our study found that the complete response, partial response of self-efficacy, understanding social support score, family support and family support scores were significantly higher than partial stability, disease progression, difference between statistical significance (P<0.05). Conclusions  the subjects have the higher level for the self-efficacy and perceived social support in patients with esophageal cancer during the concurrent chemoradiation, The perceived social support is higher in patients, the self-efficacy is higher.
2019 Vol. 6 (1): 70-74 [Abstract] ( 440 ) HTML PDF (1155 KB)  ( 303 )
75 Expression and clinical significance of miR-10a and let-7i in endometrial carcinoma
1QI Li-ning, 2ZHANG Hong-zhen, 2WEI Xu-jing, 1GUO Yan-pu, 1ZHAI Ai-li, 1WANG Qi, 1LI Miao
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.014
 Objective  To investigate the expression of miR-10a and let-7i in endometrial carcinoma tissues and its significance. Methods  Forty cases of endometrial carcinoma，twenty cases of atypical hyperplasia and thirty cases of normal endometrium tissues were collected, poly (A)-RT-qPCR was employed to test the expression of miR-10a and let-7i in different endometrial tissues. The statistical analyses were performed between the expression of miR-10a and let-7i and the clinicopathological characteristics. Results  The expression of miR-10a was higher in endometrial carcinoma tissues than that of normal endometrium and atypical hyperplasia tissues (P<0.01). The expression of miR-10a in patients with grade 3 of pathology was higher than that 1+2, in stage Ⅲ+Ⅳof endometrial carcinoma patients was higher than stageⅠ+Ⅱ, in patients with lymph node metastasis was higher than that without lymph node metastasis , in patients that myometrial invasion≥1/2 was higher than that<1/2. The expression of miR10a in different age, whether ER-positive, PR-positive had no statistical difference (P>0.05).  The expression of let-7i was lower in endometrial carcinoma tissues than that of normal endometrium and atypical hyperplasia tissues (P<0.01)。Conclusions  In endometrial carcinoma tissues, the expression of miR-10a was up-regulated, let-7i was down-regulated, miR-10a may promote invasion and metastasis of endometrial carcinoma.
2019 Vol. 6 (1): 75-78 [Abstract] ( 370 ) HTML PDF (1092 KB)  ( 303 )
79 The clinical significance of survivin mRNA expression in peripheral blood of patients with colorectal cancer
1WANG Qian, 1LIU Jie, 1WANG Ning, 1QI Hong-bing, 2MO Fu-quan, 1ZHOU Wen-su, 3ZHANG Pei-jun
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.015

 Objective  To explore the expression of survivin mRNA in peripheral blood of patients with colorectal cancer and its clinical significance. Methods  SPSS16.0 software was used for statistical analysis. χ2 test was used. Collected 90 patients with colorectal cancer and 60 patients with colorectal adenoma disease in general surgery of baoding first central hospital. 60 healthy people were selected as control group during the same period. The expression of Survivin in serum of patients with colorectal cancer, patients with colorectal adenoma disease and healthy controls before operation was detected and compared by nested RT-PCR. To analyze the correlation between the level of Survivin mRNA in serum of patients with colorectal cancer and clinicopathological features such as stage, pathological type, degree of differentiation and distant metastasis after operation. Results  Survivin was not expressed in healthy people. Survivin was expressed in 2 patients with benign colorectal adenoma (3.33%) and 49 patients with colorectal cancer (54.44%) in peripheral blood. The expression rate of survivin was closely related to tumor stage and distant metastasis (P<0.05). Significant correlation (P>0.05). Conclusions  The expression of survivin in peripheral blood of patients with colorectal cancer is significantly up-regulated, which is closely related to the stage and distant metastasis of colorectal cancer. It can be used as a good molecular marker to detect metastasis in peripheral blood of patients with colorectal cancer and to evaluate the progress of cancer.
2019 Vol. 6 (1): 79-82 [Abstract] ( 468 ) HTML PDF (1385 KB)  ( 254 )
83 Correlation between serum leptin level and hepatocellular carcinoma (HCC) based on hepatitis B cirrhosis
1FENG Juan, 1FAN Xiao-tang, 1HALIDA Xiaerfuhazi, 2REN Zhi-hui, 3Li Liang, 1HE Fang-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.016
 Objective  This study is to investigate the correlation between the serum leptin level and the occurrence of hepatocellular carcinoma based on hepatitis B cirrhosis, as well as the clinical features of patients with high Leptin level.  Methods  In this prospective study, totally 232 cases of HCC based on hepatitis B cirrhosis were included, and another 200 age-gender-matched cirrhosis patients with Child-Pugh A liver function was recruited as the pair control group. Serum Leptin level was determined with ELISA. Multivariate logistic regression analysis was performed to investigate the possible related factors for HCC. Results  Among these 432 subjects, totally 95 pairs were obtained and analyzed. The average ages for the HCC and cirrhosis groups were 49.91±9.901 and 50.32±10.759 years, with significant inter-group differences. The male to female ratio was 77/18, and the ratio of Han/ Uyghur/ Kazak ethnicities was 92/2/1. For the HCC group, there were 26 patients (27%) combined with obesity and type II diabetes, and 18 patients (19%) combined with obesity or type II diabetes. For the cirrhosis group, there were 47 patients (49%) combined with obesity and type II diabetes, and 6 patients (6%) combined with obesity or type II diabetes. The multivariate logistic regression analysis involved Leptin, ferritin, CRP, AFP, BMI, and type II diabetes. Conclusion  Serum Leptin level represents the risk factor for HCC based on hepatitis B cirrhosis, and elevated serum Leptin level might be the marker for hepatitis B cirrhosis combined with metabolic factors such as obesity.
2019 Vol. 6 (1): 83-88 [Abstract] ( 345 ) HTML PDF (1897 KB)  ( 294 )
89 Medical Supervision for Cancer Patients' Healthy Lifestyle (MCL) improves postoperative rehabilitation
1ZHANG Xin,?1WU Xiao-jun,?2LUO Ming,?3XIONG Li-long,?4DU Chi,?5SHI Han-ping
DOI: 0.16689/j.cnki.cn11-9349/r.2019.01.017
 Objective  To explore the effect of Medical Supervision For Cancer (Chronic Disease) Patients' Healthy Lifestyle (MCL) on the postoperative rehabilitation of tumor patients. Methods  Fifty patients with solid tumor were randomly assigned into the intervention group or the control group. Twenty-five patients in the intervention group were given MCL during perioperative period, while another 25 cancer patients with the same disease background were subjected to routine clinical treatments. Hospital stay, postoperative complications, nutritional risk screening, nutritional assessment, main laboratory values and quality of life of 2 groups were compared. Results  All 50 patients completed the operation as planned. The differences in hospital stay, postoperative complication incidence rate, nutritional assessment and KPS score were statistically significant between 2 groups (P<0.05). The values of leukocyte, lymphocyte, hemoglobin, platelet of 2 groups have no statistically significant difference (P>0.05). The emotional function, nausea and vomiting, loss of appetite, insomnia and diarrhea in the intervention group were significantly improved compared with the control group (P<0.05). PG-SGA score is correlated with total protein, prealbumin and albumin levels (P<0.05). Conclusions  MCL can shorten the hospital stay, reduce the incidence of postoperative complications, improve nutritional status, enhance serum total protein, prealbumin and albumin levels, improve emotional function, reduce the incidence of nausea and vomiting, appetite loss, insomnia and diarrhea.
2019 Vol. 6 (1): 89-93 [Abstract] ( 528 ) HTML PDF (1113 KB)  ( 439 )
94 To explore the predictive value of prognostic nutrition index (PNI) for clinical outcomes in selective surgery of gastrointestinal tumors
1LIU Ni, 1FANG Yu, 2JI Jia-fu
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.018
 Objective  To explore the application value of prognostic nutrition index (PNI) in gastrointestinal cancer patients by comparing with nutritional screening tool NRS 2002 and nutrition assessment tool PG-SG. Methods  A prospective application of nutritional screening or assessment tools PNI, NRS 2002 and PG-SGA, into a group of unconsecutive cases of gastrointestinal cancer patients were carried. To draw the receiver operating characteristic (ROC) curve of PG-SGA and PNI according to NRS 2002 results, analyzing the difference between tools involving sensitivity and specificity, positive predictive value, negative predictive value, Yueden index and the area under the curve. To compare the nutrition related indicators between the two groups divided by the cutoff point. The Kappa test was used to compare the diagnostic consistency between the different diagnosing tools. Results  The area under the PG-SGA curve is 0.936 (95%CI=0.893~0.979), the Yueden index is 0.778, the cut-off value is 7.5, the sensitivity is 84.6%, the specificity is 93.2%, the positive predictive value is 97.3%, and the negative predictive value is 52,8%. Consistency was checked P=0.000. Maximum value of PNI was 75.6, and minimum value 29.35. ROC curve showed that area under the PNI curve was 0.584 (95%CI=0.480~0.688), the Yueden index is 0.196, the cut-off value of PNI is 53.8, the diagnostic sensitivity was 89.7% by this cutoff point , specificity was 29.9%, the positive predictive value was 63.2% and negative predictive value was 13.3%. The consistency test with NRS 2002 P=0.015. The patients were divided into two groups (by cut-off value PNI=53.8), there were statistically significant difference of weight, height, ALb and TLC between the two groups (P<0.05). While BMI and TLC had significant difference between the two groups devided by PG-SGA≥8 (P < 0.05). The consistency between the two methods of PG-SGA and PNI is P=0.000. There was no statistically significant difference about the total incidence of complications between the two groups divided by three evaluation tools (P>0.05). Conclusions  For patients with surgical gastrointestinal tumor, PNI=53.8 can serve as a cut-off diagnostic threshold for nutritional risk with more significant difference in related nutritional indexes. There was no significant difference in the total incidence of postoperative complications between the two groups districted by the three tools respectively.
2019 Vol. 6 (1): 94-98 [Abstract] ( 451 ) HTML PDF (1442 KB)  ( 348 )
99 The progresses and challenges of cancer pain in modern era
YANG Guang, SHANG Xiao, WANG Nan-ya
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.019
 Pain is one of the most common symptoms among cancer patients. About 60%-80% of patients with advanced cancer suffer from pain. Cancer pain can cause or aggravate physical symptoms, and can also cause psychological burden, which directly affects patients' quality of life. Cancer pain is a global public health problem. The World Health Organization (WHO) has set a strategic task to relief pain and its painful symptoms to overcome cancer. In 1986, the WHO proposed a three-step treatment regime for cancer pain, which made great progress in cancer pain control, but still about 20% of cancer patients suffer from pain. Poor pain management, which also poses new challenges for clinically effective treatment of cancer pain, especially for patients with advanced cancer. The United States National Cancer Network (NCCN) lists the cancer pain management as an important part of cancer control. Furthermore, cancer pain management is integrated into the comprehensive treatment of cancer in almost all countries worldwide. Paying attention to the influence of pain on cancer patients is important to oncologists. Knowing how to manage cancer pain effectively are essential skills for clinical stuff. In modern era, new progresses and new challenges have emerged in the diagnosis and treatment of cancer pain. This article will give a summary of the challenges and recent advances of cancer pain in recent years.
2019 Vol. 6 (1): 99-103 [Abstract] ( 424 ) HTML PDF (1254 KB)  ( 446 )
104 Application of bioelectrical impedance analysis to measure body composition in cancer patients
YAN Chao,WANG Dan-dan, DU Hong-zhen, XIE Ying, LUO Bin, LI Zeng-ning
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.020
 Bioelectrical impedance analysis is non-invasive, validated method to assess body composition and nutritional status, which offers an efficacious way to track changes in body composition over time. Cancer patients have different rates of malnutrition due to the type, location, stage, and treatment route of the tumor. Malnutrition is commonly reported in cancer patients and can increase mortality and treatment complications, and can reduce treatment effectiveness and quality of life. Cancer patients are usually at risk of developing cachexia, which is associated with progressive weight loss, loss of muscle and fat tissue, impaired immune function, and metabolic disturbances caused by a variable combination of reduced food intake, systemic inflammation and abnormal metabolism. The bioelectrical impedance analysis method can qualitatively and quantitatively analyze the composition of different tissues in the body and accurately reflect the changes of the components of the body. It is a good tool for evaluating the nutritional status of cancer patients. Studies indicate that the use of bioelectrical impedance analysis and phase angle measures can benefit in the clinical management of cancer patients in multiple ways: in the prevention, diagnosis and prognosis. The phase angle and fatfree mass obtained by bioelectrical impedance analysis has been used as a predictor of nutritional status and survival rate in cancer patients. This systematic review sought to summarise current literature surrounding body composition assessment in cancer patients to provide a basis for clinical nutrition monitoring and nutritional support.
2019 Vol. 6 (1): 104-109 [Abstract] ( 475 ) HTML PDF (2479 KB)  ( 536 )
110 Sarcopenia and cancer chemotherapy
1,2ZHANG Fu-feng, 3LU Xiao-qin
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.021
 Sarcopenia is considered as a clinical syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, and impaired muscular function. Sarcopenia has recently emerged as a new condition and more recently research has focused on cancer patients who appear to be especially exposed to this risk. Sarcopenia has received great attention by clinicians in the oncology field. Sarcopenia is the major feature of cancer cachexia, and is associated with reduced quality of life and survival. There are several reasons for muscle mass depletion in cancer patients, such as higher energy expenditure, anorexia, inflammation and unbalanced cancer metabolism. To explore the relationship between sarcopenia and cancer chemotherapy, purpose of this review is to define the diagnosis of sarcopenia in cancer patients, the prevalence of sarcopenia in cancer patients, its role in leading to chemotherapy toxicity and its effect on the prognosis in cancer patients. Finally, the review also aims to describe the current approaches to restore the muscle mass and the effects on the therapy in cancer patients.  Recent researches has allowed the oncologist to evaluate the muscle mass and to collect many data on the prevalence of sarcopenia and its clinical consequences. The oncologist should coordinate this multimodal approach by selecting priorities and sequences of treatments and then involving a nutrition health care professional or a physical therapist depending on the condition of the single cancer patient and improve the outcome of the cancer patients.
2019 Vol. 6 (1): 110-115 [Abstract] ( 423 ) HTML PDF (1273 KB)  ( 385 )
116 Progress of ribosomal protein in malignant tumor therapy
1, 3YUAN Fei, 2, 3, 4WANG Shu-bin
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.022
 Ribosomal protein (RP) is abnormally expressed in various tumors, and affects apoptosis, senescence, growth, invasion, drug and radiation therapy resistance of tumor cells through various mechanisms. The expression level of RP in tumors is closely related to the pathological grade and clinical stage of the tumor, and it becomes a potential indicator for tumor diagnosis, treatment and prognosis. RP can be modified by phosphorylation or the like to change its activity and mode of action in tumor development. The mechanism of action of RP is different from that of chemotherapy drugs, which can regulate the sensitivity of tumor cells to drugs, so as to reverse the multi-drug resistance of tumor cells in a low-toxicity and effective way. By regulating the RP to redistribute the cell cycle, the cell cycle of the tumor is arrested in the G0-G1 phase, reducing the proportion of cells in the G2-M phase. The RNA polymerase I protease involved in RP synthesis was used as a target to indirectly regulate the treatment of RP, and showed significant antitumor activity in animal models. The drug acting on RP has no obvious cytotoxicity due to its direct effect on the genome, and has low genotoxicity to the differentiated mature normal tissue cells and has better targeting. Obviously, tumor treatment for RP is highly specific and can effectively reverse multidrug resistance and radio-sensitization, providing a potentially low-toxic treatment.
2019 Vol. 6 (1): 116-119 [Abstract] ( 484 ) HTML PDF (978 KB)  ( 405 )
120 Nutrition screening methods and evaluation tools for Three-level diagnosis of malnutrition in primary liver cancer
TANG Zhong-quan
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.023
The aim of this paper is to rationally select nutritional screening methods and evaluation tools and accurately determine the nutritional status of patients with PLC. This paper is based on the three-level diagnosis of malnutrition established by the Chinese Anti-cancer Association. By reviewing domestic and abroad literature , the methods and evaluation tools of the first-level diagnosis (nutritional screening), the second-level diagnosis (nutritional assessment) and the third-level diagnosis (comprehensive evaluation) for PLC patients were summarized and analyzed. The first-level diagnosis methods include NRS 2002, MUST and BMI. NRS-2002 is suitable for nutritional screening of PLC patients while the sensitivity of MUST is poor. BMI is the most direct and simplest nutritional screening method. It is not suitable to be used as an independent screening method for PLC patients because it is easily affected by body weight. The second-level diagnosis methods include SGA, PG-SGA and MNA. PG-SGA is a sensitive assessment tool for malnutrition among PLC patients. The sensitivity of SGA and MNA is poor. In addition to medical history collection, physical aptitude and physical examination, three-level diagnosis includes anthropological measurements of MAC, TSF and HGS, which has a higher accuracy in the determination of malnutrition in PLC patients because its directness and objectivity. Laboratory examination of TLC, ALB, PA, which has a poor sensibility, BIA and L3-SMI, which is able to accurately reflect the nutritional status of PLC patients and is not suitable for large-scale clinical use because it is easily affected by equipment and conditions. The results showed that NRS 2002 and PG-SGA are the preferred nutritional screening method and evaluation tools for PLC patients. Combined with MAC, TSF, HGS, BIA and L3-SMI, the nutritional status of PLC patients are able to be accurately evaluated.
2019 Vol. 6 (1): 120-124 [Abstract] ( 455 ) HTML PDF (1062 KB)  ( 390 )
125 Clinical research progress of the systematic treatment for advanced non-small cell lung cancer in the elderly
BAI Ri-lan, CUI Jiu-wei
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.024
Elderly patients are the main group for non-small cell lung cancer (NSCLC). Due to the increased age, the multi-organ reserve of elderly patients decrease, the incidence of comorbidities is higher, resulting in lower tolerance than younger patients, and the choice of treatment options is limited. Therefore, the effective assessment of the physical condition of elderly patients with advanced NSCLC and the choice of treatment options have become the current challenges and the focus of attention. Systemic treatment of elderly patients, such as chemotherapy, targeted therapy and immunotherapy for advanced NSCLC, has been gradually studied and made breakthrough progress. Overall, for chemotherapy, a number of clinical trials conducted in the elderly have shown satisfactory results with platinum-based combination therapy; for anti-angiogenic agents, there is currently insufficient evidence to show the safe use in elderly patients; TKI drugs show good response and tolerability in elderly patients with specific driver mutations, but specific driven gene mutations occur less frequently in older patients; immune checkpoint inhibitors, the strategy of which is to improve the immune status of cancer patients, also achieves effect in elderly patients to a certain extent, so age should not be the only factor to measure whether to receive immunotherapy. This paper reviews the latest research progress and related guidelines for systemic treatment of the elderly population, and hopes to provide a reference for guiding the choice of treatment options for elderly patients.
2019 Vol. 6 (1): 125-134 [Abstract] ( 404 ) HTML PDF (1152 KB)  ( 346 )
135 Sarcopenia
1CAI Jun-xiang, 2LOU Hui-ling
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.025
 Sarcopenia is a syndrome associated with low muscle mass, muscle strength and physical performance. The morbidity rate of sarcopenia is pretty high in elderly people who are lake of physical activity, chronic disease patients and patients with malignancy. Patients have higher risks of falling, frailty and disability, and are more likely to be independence. Sarcopenia also impact on the quality of life and clinical outcome directly, and if we pay enough attention to sarcopenia early in life, it can help us delaying frailty. Sarcopenia are categorized as aged-related sarcopenia, sarcopenia with malnutrition, sarcopenia associated with activity, disease-related sarcopenia. Aging, endocrine changes, chronic inflammation, cachexia, malnutrition, vitamin D deficiency can lead to sarcopenia. The European Working Group on Sarcopenia in Older People revises their consensus recently, and  recommends using muscle strength as the most important parameter of sarcopenia, and they updates its algorithm for sarcopenia casefinding, diagnosis and severity determination. Mechanism of sarcopenia has been realized within more and more studies developping. Nutrition supplement, resistance exercise and hormone replacement therapy can improve muscle mass and strength, delay function decline, improve quality of life. Etiology of sarcopenia is not integral yet, pharmacotherapy still needs more powerful evidence.
2019 Vol. 6 (1): 135-143 [Abstract] ( 486 ) HTML PDF (1448 KB)  ( 871 )
144 Impact factors and clinical significance of the browning of white adipose tissue
1TANG Hai-ling, 2LU Xiao-lan, 3SHEN Sheng-rong
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.026
The adipose tissue is an extreme important tissue for energy storage. There are three types of adipose tissue in mammals: white fat tissue, classic brown adipose tissue, and inducible brown adipose tissue, or beige adipose tissue. The main function of white fat tissue is to store energy in the form of triglyceride and maintain the endocrine function. The main function of classic brown adipose tissue and inducible brown adipose tissue is to generate heat and maintain the energy balance of the body. Cold environment and exercise can stimulate the browning of white adipose tissue, and PRDM16, PPARγ and PGC-1α are the three core transcription factors related to this process. The browning of white adipose tissue is a complex process involving many factors. Previous studies showed that the browning of white adipose tissue is beneficial to the treatment of obesity, diabetes, fatty liver, and other diseases, on the other hand, it can promote the progress of the patients with malignant tumor. Also, it can be seen that different types of adipose tissue always maintain a dynamic balance in healthy human body. How to intervene in various types of adipose tissue at the early stage of metabolic imbalance, through key targets, will be a new idea for the further researches.
2019 Vol. 6 (1): 144-149 [Abstract] ( 435 ) HTML PDF (1834 KB)  ( 535 )
150 Research progress on relationship between mtDNA and tumor
1FENG Da-li; 2ZHU Wen-liang; 3YIN Yi-fa
DOI: 10.16689/j.cnki.cn11-9349/r.2019.01.027
 With the rapid development of modern society, the incidence of human tumors has been increased year by year, posing a serious threat to human health. There are more and more researches on tumors, among which there are many studies on mitochondrial DNA(mtDNA) and tumor. Especially in recent years, the research on mtDNA and tumor has gradually become the focus of tumor research. MtDNA research involves point mutation, fragment deletion, content change and so on. This paper comprehensively collated the relevant research on mtDNA content in tumors, reviewed the relevant research literature on mtDNA content in different tumors at home and abroad in past 10 years, found out the research methods and relevant data and data obtained for induction, analysis and summary. It is found that there are many studies on mtDNA content in tumors, and the types of tumors studied are diverse, involving the occurrence, development, treatment and prognosis of different tumors. The results of different studies are not the same, or even the opposite. However, a large number of studies have shown that mtDNA content changes in the occurrence and development of tumors, and mtDNA content changes have  impacts on the occurrence, development, treatment and prognosis of tumors and so on. mtDNA content changes play a different role in different tumors and at different stages of tumors, and the mechanisms are diverse. These research data provide theoretical reference for the related studies of tumor  mtDNA content in the future, and it is expected to make contributions to the diagnosis and treatment of tumor.
2019 Vol. 6 (1): 150-154 [Abstract] ( 422 ) HTML PDF (1093 KB)  ( 318 )
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