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2019 Vol. 6, No. 2
Published: 2019-06-09
 
155 The explanations on several terms of clinical nutrition
SHI Han-ping, WANG Xiao-lin, YANG Yun
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.001
Clinical nutrition is a dynamic discipline that undergoes continuous evolving. Outdated concepts are being challenged, and new terminologies are being created constantly. It is a necessity to employ terms that are unified, standardized, up-to-date in the field for an effective communication, research and application and to avoid uncertainty or confusion. In this paper, some new terminologies are introduced in terms of nutritional science, nutritional diagnosis, nutrition-related conditions, and nutrition therapy. Meanwhile, several existing terms are redefined. Introductions made to nutrition science include redefining human nutrition, preventive nutrition, and clinical nutrition. The concepts have been updated for three-level diagnosis, nutritional screening, nutritional assessment, and comprehensive evaluation. Moreover, this paper defines nutrition disorder, malnutrition, and sarcopenia. A series of terminology is updated regarding nutrition therapy, including nutrition team, nutritional care and types of therapy, nutrition intervention and its related terminologies. The aim of the present paper is to encourage the discussion in the field and to set a foundation for further standardization of terminologies for clinical nutrition.
2019 Vol. 6 (2): 155-160 [Abstract] ( 521 ) HTML PDF (3016 KB)  ( 401 )
161 The correlation between intestinal microecology and the efficacy of chemotherapy
ZIWAREGULI Nur, FANG Ruo-xin，LIAO Zheng-kai
DOI: 10.16689/j.cnki.cn11－9349/r.2019.02.002
There is a symbiotic or antagonistic relationship between human intestinal flora, and a unique intestinal microecosystem is formed. After a long period of co-evolution, intestinal flora and human body have formed a close symbiotic relationship, and participate in many important physiological activities of the human body. Therefore, maintaining the balance of intestinal flora is essential to human health. The formation of human intestinal flora structure depends on many factors, such as diet, sex, mode of delivery, host genetic characteristics, host lifestyle, disease occurrence and antibiotic exposure. Escherichia coli, bifidobacteria, Lactobacillus and Proteus are the main intestinal flora in healthy people. Under normal physiological conditions, these bacteria maintain a dynamic balance of species and quantity. They can not only protect intestinal epithelial cells, but also participate in the physiological processes of immunity, nutrition, biological antagonism, anti-aging and anti-cancer in the life activities of the host. Intestinal flora can inhibit the occurrence and development of tumors and regulate inflammation by activating anti-tumor cytokines, regulating intestinal microenvironment and maintaining genomic stability. Moreover, the complete intestinal flora is also conducive to the development of anti-cancer drugs. Intestinal flora can affect the efficacy and toxicity of chemotherapy through flora translocation, immune regulation, metabolism, enzymatic degradation, diversity reduction and microecological changes. At the same time, chemotherapy can significantly affect the composition of intestinal flora, destroy the balance of intestinal microecology, and aggravate the discomfort of patients. More and more evidences show that intestinal bacteria can affect the efficacy or toxicity of chemotherapy, and that intestinal microecology may improve the efficacy and reduce toxicity of chemotherapy. This article reviews the relationship between intestinal flora and the efficacy and side effects of chemotherapy.
2019 Vol. 6 (2): 161-166 [Abstract] ( 454 ) HTML PDF (978 KB)  ( 310 )
167 Progress in the study of the complex correlation between neutrophil and tumor
GUO Fei-fei， CUI Jiu-wei
DOI: 10.16689/j.cnki.cn11－9349/r.2019.02.003
Neutrophils have multiple functions， including the ability to secrete chemokines and cytokines， the ability to form extracellular traps， antigen presentation， and the ability to regulate tumor proliferation and metastasis. The findings of neutrophil plasticity and heterogeneity suggest that circulating neutrophils and tumor-associated neutrophils play a significant role in the regulation of tumor proliferation and metastasis. On the one hand， neutrophils promote tumor inflammation， tumor cell proliferation and invasion， and tumor angiogenesis. Besides， it can promote tumor immune escape by inhibiting the activity of cytotoxic T cells. On the other hand， neutrophils can promote the antitumor effect of T cells and participate in tumor inhibition by producing corresponding cytokines. Previously， the study of tumor-associated neutrophils was based on animal models. Recently， some studies have further pointed out the understanding of human tumor-associated neutrophil， and explored the possibility of neutrophils becoming a new target of tumor immunotherapy. At present， many studies on the complex relationship between tumors and neutrophils have shown that cell therapy plays an important role in the understanding of tumor biology， the development of tumor markers and the treatment of tumor. This article reviews the progress in the study of the relationship between neutrophils and tumor complexity.
2019 Vol. 6 (2): 167-171 [Abstract] ( 420 ) HTML PDF (2018 KB)  ( 325 )
172 Impact of obesity on therapy response and clinical outcomes in cancer patients
CHONG Xiao-yi， ZHANG Xiao-tian
DOI: 10.16689/j.cnki.cn11－9349/r.2019.02.004
The world health organization defines obesity as a body mass index (BMI) of no less than 30. Because of the small size of the oriental human body， obesity is defined as BMI ≥ 28 in China. There is a large amount of obesity patient in our country， which is nearly 90 million in 2014. Many researches showed that obesity is associated closely with the incidence of tumors. Currently， there are about 13 types of obesity-related tumors. Therefore， ensuring that BMI is within the normal range is still a correct choice for avoiding the risk of cancer. At the same time， obesity also affects the therapy response and long-term survival of cancer patients. Many studies have shown that obesity may have an effect during the whole process of tumor treatment. With the increasing incidence of obesity and tumor， the treatment for obese cancer patients in clinical practice has become an issue which clinicians need to consider. For a long time， obesity has been regarded as a stumbling block in cancer treatment. However， in recent years， some studies have identified the dual role of obesity in the efficacy of surgery， chemotherapy， targeting therapy， and immunotherapy， in other words， “obesity paradox”: overweight and mildly obese cancer patients have the better survival benefit and response to therapy， while moderate to severe obesity and underweight are related to poor prognosis. Researchers now recognize that obesity may affect the cancer treatment in another way. Therefore， the weight management， treatment strategy， and long-term survival prediction of obese tumor patients need to be explored and established through further pre-clinical research and clinical practice， and a more detailed and in-depth understanding of the relationship between obesity and tumor will be warrant for prevention and treatment of cancer. This article reviews the effects and advanced progress of obesity on cancer treatment.
2019 Vol. 6 (2): 172-177 [Abstract] ( 479 ) HTML PDF (1408 KB)  ( 290 )
178 Advances in research on intestinal microecology and clinical outcomes of tumors
SHENG Xiang， LI Su-yi
DOI: 10.16689/j.cnki.cn11－9349/r.2019.02.005
The number of parasitic bacteria in the human intestinal tract reached 1014， more than 10 times the number of human cells， including symbiosis and pathogenic microorganisms， which jointly formed the microbial ecological community， namely the intestinal microecology. The intestinal tract provides a place for the growth and reproduction of microorganisms， while microorganisms provide the host with enzymes and biotransformation pathways that are not available in the human body. Therefore， they can decompose the polysaccharide oligosaccharide glycoprotein that is not easily digested by the human body， generate short-chain fatty acids， provide energy for the host， and provide nutrients for the growth and reproduction of intestinal flora. Secondly， intestinal microorganisms produce effects through co-metabolism with the host. For example， multiple metabolic pathways， such as fat emulsification， cholesterol absorption， and enterohepatic circulation， are involved in the catabolism of drugs and other foreign compounds. In addition， intestinal microorganisms form barrier effects against pathogenic microorganisms through their own surface antigens and the host immune system. There is increasing evidence that intestinal microecology plays an important role in the process of tumorigenesis， development and treatment， and has extensive connections with the host. So far， some achievements have been made in the treatment of intestinal microecology intervention with certain means. With the deepening of the research on the relationship between intestinal microecology and tumor， valuable discoveries and inspirations keep emerging. Further exploration and excavation are helpful to improve the understanding of intestinal microecology， hoping to provide more feasible solutions for anti-tumor treatment. This article reviews the advances in clinical outcomes of malignant tumors and intestinal microecology.
2019 Vol. 6 (2): 178-182 [Abstract] ( 446 ) HTML PDF (1408 KB)  ( 323 )
183 Expert consensus on clinical use of compound amino acid injection
GAO Chun， LI Meng， WEI Jun-min， LI Yu-zhen， TIAN Wei-jun， JIANG Hai-ping， SHEN Wei， XU Ai-guo， YU Zhen， CHEN Dong-sheng， CHEN Lian-zhen， GUAN Wen-xian， JIANG Hua， LI Da-kui， MEI Dan， YU Ji-ren， ZHAO C
DOI: 10.16689/j.cnki.cn11－9349/r.2019.02.006
Compound amino acid injection， as the source of nitrogen in parenteral nutrition， is administrated to patients with compromised gastrointestinal function or whose nutritional needs cannot be satisfied via the GI tract. Therefore， compound amino acid injection is crucial in nutrition therapies. However， a consensus does not exist in China regarding its indications， formulations， dosages， and the timing of administration. Experts in the field are recruited by the Chinese Society for Parenteral and Enteral Nutrition (CSPEN) and the Chinese Society of Nutritional Oncology (CSNO) to formulate a consensus paper. The current paper aims to provide standardized guidance for clinical use of compound amino acid injection. The consensus paper is a composite of systematically reviewing pertinent literature， Chinese clinical practice， and multiple sessions of debate， discussion， and composition， with reference to guidelines from American Society for Parenteral and Enteral Nutrition (ASPEN)， European Society for Clinical Nutrition and Metabolism (ESPEN)， CSPEN， and CSNO. This consensus presents 10 recommendations for protein needs and appropriate compound amino acid injection formulas to serve varied patients.
2019 Vol. 6 (2): 183-189 [Abstract] ( 1462 ) HTML PDF (541 KB)  ( 898 )
190 Combined life style guidance and early dietary fiber supplementation to improve slow transit constipation: a self-controlled study
ZHANG Ling， LIU Gao-lei， ZHANG Meng-yuan， LIU Jie，1UO Jing， LIN Xin， XU Hong-xia， LI Chun-xue
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.007
Objective To explore the effects of combined lifestyle guidance and early dietary fiber intervention on slow transit constipation. Methods 82 patients diagnosed with slow transit constipation at out-patient department of Daping Hospital， Army Medical University were prospectively included from October 2015 to November 2016. Dietary， exercise and constipation status were investigated. Lifestyle guidance was given via one-to-one interview. Oral intervention of dietary fiber complex was continuously given to each subject for 10days. Daily dietary intake and exercise amount of subjects were monitored by monthly telephone interview. One and six month after intervention beginning， follow-up was performed to evaluate constipation improvement， dietary intake， water consumption， exercise change， weekly stool frequency， stool consistency (Bristol Stool Score)， Patient Assessment of Constipation Symptoms score (PAC-SYM score). Results Among 82 patients， 7 subjects were lost to follow-up. Finally， data from 75 patients diagnosed with slow transit constipation was analyzed. The results showed that proportions of the following patient groups were elevated， including patients with balanced meat and vegetables， patients with combined whole grains and refined grains as their staple food， patients with 100-150g daily animal food consumption， patients with one share of daily fruit consumption， patients with 1，500-2，000ml daily water consumption and patients with regular exercise. Compared with baseline， the patient’s stool frequency increased significantly［(1.40±0.77) vs (3.67±1.20) vs (3.62±1.17)， both P<0.05］ at 1-mo and 6-mo. Meanwhile the defecate feeling demonstrated a significant reduction［(1.48±1.26) vs (1.13±1.24) vs (0.89±1.10) both P<0.05］ and Bristol scores increased remarkably［(1.99±1.34) vs (3.89±0.95) vs (3.87±0.99) both P<0.05］. The PAC-SYM scores had s significant reduction［(2.21±0.42) vs (1.43±0.57) vs (1.51±0.46) both P<0.05］. The clinical improvement rates reached 88.00% and 86.67%， respectively. Self-satisfaction rates were 85.33% and 80.00%， respectively. Conclusion As an integrative clinical measure， combined treatment with lifestyle guidance and early dietary fiber supplementation is effective to improve symptoms and satisfaction degree of patients with slow transit constipation.
2019 Vol. 6 (2): 190-195 [Abstract] ( 434 ) HTML PDF (950 KB)  ( 406 )
196 Correlation between platelet/lymphocyte ratio and clinical prognosis of small cell lung cancer
WANG Li-wei， WANG Jian-wei， JIA Wei， QIANG Wei， XUE Mei， MA Chao， WEI Xiu-qin
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.008
Objective To investigate the relationship between platelet to lymphocyte ratio (PLR) and prognosis in patients with small cell lung cancer (SCLC). Methods Clinical data， including platelet and lymphocyte counts， of 165 patients with SCLC admitted to our hospital from June 2008 to June 2018 were collected and retrospectively analyzed and their survival were followed up. The optimal cut-off value of PLR was determined with time-dependent receiver operating curve (ROC curve) analysis in SPSS 22.0 statistical software. The overall survival (OS) and progression-free survival (PFS) of high PLR and low PLR groups were evaluated with Kaplan-Meier analysis respectively and Multivariate Cox regression models were applied to evaluate the independent prognostic significance of PLR. Results ROC curve analysis showed that PLR ＝ 189 was optimal cut-off value. One hundred and twenty cases were found in the low PLR (<189) group and 45 cases fell in the high PLR (≥189) group. The progression-free survival of patients with low PLR was higher than that of high PLR (8.6 months vs 6 months， P=0.016). The overall survival of patients with low PLR was higher than that of high PLR (13.8 months vs 12.1 months， P= 0.016). COX multivariate regression analysis showed that radiotherapy can be used as an independent prognostic factor for both PFS and OS in patients with SCLC(HR=0.488， 95%CI=0.303~0.787， P=0.003； HR=0.314， 95%CI=0.190~0.519， P=0.000. PLR level can be used as an independent prognostic factor for PFS in patients with SCLC (HR=1.538， 95%CI=1.040~2.274， P=0.031)， but not as an independent prognostic factor for OS (HR=1.323， 95%CI=0.883~1.982， P=0.175). Conclusion PLR can reflect the prognosis of patients with SCLC， but it cannot be used as an independent prognostic factor.
2019 Vol. 6 (2): 196-199 [Abstract] ( 463 ) HTML PDF (879 KB)  ( 308 )
200 null
LI Na， LIU Jie， LIN Xin， ZHANG Hong-mei， ZHANG Meng-yuan， SHI Mu-li， HE Xiu-mei， XU Hong-xia
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.009
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2019 Vol. 6 (2): 200-205 [Abstract] ( 540 ) HTML PDF (494 KB)  ( 402 )
206 Clinical application and research of abdominal retrograde gastric and jejunal feeding tube
ZHANG Chong， CAO Long-xiang， LV Ying-ying， WANG Ying， WANG Lu-ming， LV Wang， HU Jian
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.010
Objective To summarize clinical application and experience of abdominal retrograde gastric and jejunal feeding tube and study its clinical value. Methods We viewed 45 adult patients with esophageal carcinoma treated with two-incision esophagectomy from January 1st， 2014 to December 31th， 2016 in Department of Thoracic Surgery， the First Affiliated Hospital of Zhejiang University. During the surgeries， 31 patients were treated with nasogastric tube and jejunostomy tube (control group)， and 14 patients were treated with retrograde gastric tube and jejunostomy tube (abdominal retrograde gastric and jejunal feeding tube， experimental group). All of them were diagnosed with esophageal squamous cancer according to the postoperative pathological results. Results Differences of general information between two groups including gender， age， body mass index， smoking history， preoperative albumin， preoperative alanine aminotransferase， preoperative aspartate aminotransferase， preoperative hemoglobin， location and pathological TNM stage were not statistically significant (P>0.05). Operative time， operative blood loss， postoperative albumin， postoperative hemoglobin， duration of using gastric tube， length of postoperative stay and complication rate between the two groups were not statistically different (P>0.05). The experimental group had less postoperative drainage volume of gastric tube in 24h (P＜0.05). Conclusion For resectable esophageal carcinoma， abdominal retrograde gastric and jejunal feeding tube can provide effective gastrointestinal decompression and enteral nutrition while avoiding nasal irritation and inconvenience. So it deserves to be further studied and widely applied.
2019 Vol. 6 (2): 206-211 [Abstract] ( 387 ) HTML PDF (830 KB)  ( 342 )
212 Study on the relationship between Glasgow prognostic score and nutritional， physical status in patients with gastric cancer
GE Shao-hua， CHEN Xing-yun， ZHANG Hai-yang， NING Tao， LI Hong-li， BA Yi
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.011
To observe the value of Glasgow prognostic score (GPS) based on systemic inflammatory response in evaluating nutritional status and performance status in patients with gastric cancer. Methods 43 patients with gastric cancer hospitalized in our hospital from January 2013 to March 2014 with body composition measurement and hematological data were collected. The relationship between GPS score and nutritional， performance status were analyzed. Results In 43 gastric cancer patients， there were 18 males and 25 females. There were 27， 14 and 2 patients with GPS scores of 0， 1 and 2， respectively. It was found there was no significant statistical relationship between GPS score with NRS 2002 (nutrition risk screening， NRS 2002) score and PG-SGA (patient-generated subjective global assessment) score. The serum level of prealbumin in patients with GPS score ≥1 was significantly lower than that of patients with GPS score 0 (P=0.048)， and there was a trend to decline in blood lymphocyte count (P=0.078). The KPS score of patients with GPS score ≥ 1 was lower (P=0.015)， and there was a trend of correlation between GPS and quality of life (P=0.076). In analysis involving body composition measurement， the mid-upper arm circumference in patients with GPS score ≥1 turned to be significantly smaller than that of GPS score 0 (P=0.042). The maximum circumferences of both legs were also obviously smaller in patients with GPS ≥1 than that of GPS 0. The upper arm muscle circumference， triceps skin fold thickness and non-dominant hand grip strength were all reduced， but no significant statistical difference was found between patients with GPS ≥1 and GPS 0. Conclusion GPS score is based on systemic inflammatory response and related to parts of nutritional indicators and performance status of gastric cancer patients. It is a promising simplified alternative index for nutritional and performance status assessment of gastric cancer patients.
2019 Vol. 6 (2): 212-215 [Abstract] ( 572 ) HTML PDF (392 KB)  ( 280 )
216 Clinical study of thalidomide plus Icotinib hydrochloride in the treatment of advanced pulmonary adenocarcinoma
JIANG Qian， WANG Yi， SUN Xiang
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.012
Objective To observe the efficacy and toxicities of thalidomide plus icotinib in the treatment of advanced pulmonary adenocarcinoma. Methods Totally 63 patients with pulmonary adenocarcinoma in the third affiliated hospital of Anhui medical college were selected for study from January 2013 to June 2015. The patients were randomly divided into control and experimental groups， control group of 30 patients received icotinib； the experimental groups， 33 cases received thalidomide combined with icotinib. The clinical efficacy， adverse reactions， survival rate and the changes of the serum vascular endothelial growth factor (VEGF)， interleukin-8(IL-8) tumor necrosis factor α (TNF-α)； fibroblast growth factor (bFGF) of the two groups were observed and compared. Results No significant differences were found in adverse reactions， such as rash， diarrhea， abnormal liver and renal function and occurrence of bone narrow suppression of both groups. The incidence of occult blood of stool in experimental groups were higher than the control groups. The objective response rate (ORR) of the control group was 43.33%， while that of the experimental group was 69.70% (P<0.05). The PFS of the experimental group was 21.12±6.56 months， while that of the control group was 19.77±6.61 months (P=0.073). The VEGF levels in the control groups were significantly lower than the experimental groups 295.0 (122.67~572.54)vs 148.0 (56.33~337.42) pg/ml(P<0.01). IL-8， TNF-α and bFGF levels between the two groups (P=0.0585)， there was no statistical difference. But IL-8 and TNF-α levels in the experimental group were lower than the control group， and bFGF levels in the experimental group were higher than the control group， suggesting a trend of difference between the two groups. Conclusion Thalidomide combining with icotinib hydrochloride is effective and well tolerated in patients with advanced pulmonary adenocarcinoma. It may be a rational choice for the standard and individualized treatment of advanced pulmonary adenocarcinoma.
2019 Vol. 6 (2): 216-220 [Abstract] ( 361 ) HTML PDF (1252 KB)  ( 240 )
221 The exploratory application of PG-SGA in nutritional assessment of elderly patients with chronic heart failure
ZHAO Sheng，LEI Li-cheng，YANG Nuo，REN Li-hui， PENG Jian-jun，LI Guang-ping，XUE Xin-ying， ZHAO Long-ting
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.013
Objective To investigate the application of PG-SGA in nutritional assessment of elderly patients with chronic heart failure. Methods A continuous approach was used to screen a total of 125 elderly patients who were hospitalized in the Beijing Shijitan Hospital， Capital Medical University and Rizhao Central Hospital from October 2017 to February 2019. According to the NYHA classification of heart failure， the patients were divided into the clinical heart failure group (grade Ⅱ~Ⅳ) and the pre-clinical heart failure group (grade I). Patients were evaluated for nutritional status using PG-SGA. The body mass index (BMI)， albumin (ALB)， pre-albumin (PA)， hemoglobin (Hb) and NT-proBNP were measured. The correlation between each test index and PG-SGA was observed. The relationship between PG-SGA score and cardiac function classification was studied. Results The incidence of malnutrition in the clinical heart failure group was significantly higher than that in the pre-clinical heart failure group (P<0.001). Compared to the patients rated unmalnutrition， the patients rated malnutrition got lower BMI， ALB， PA， Hb levels and a higher NT-proBNP level(P<0.05). PG-SGA scores and PA levels have statistically significant differences between each cardiac function classification subgroups (P<0.05). Conclusions The incidence of malnutrition in elderly chronic heart failure patients is high， and PG-SGA could be used for the nutritional assessment of these patients. PG-SGA scores might be used as an auxiliary index to evaluate cardiac function.
2019 Vol. 6 (2): 221-224 [Abstract] ( 466 ) HTML PDF  (0 KB)  ( 245 )
225 The relative factors analysis of malnutrition status and sarcopenia in elderly patients
YI Hai-wei， LI Wen-li， YU Yun-lan， MA Dong-bo
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.014
Objective To evaluate the nutritional status of elderly medicine patients with MNA-SF， to analyze the relationship between nutritional status， sarcopenia and other related factors， and to propose better clinical strategies on the evidences of nutrition treatment for elderly patients. Methods A total of 200 cases of patients aged more than 65 older who received treatment in the elderly medicine of the first affiliated hospital of Kangda college of Nanjing medical university from June 2017 to December 2017 were enrolled in this study. According to the scores of MNA-SF， the patients were divided into normal nutritional group， risk of malnutrition group and malnutrition group. The body composition was measured by body composition analyzer and in the meantime， grip strength， stride speed and laboratory index were evaluated. Results Among the 200 elderly medicine patients， the incidence of normal nutritional status， the risk of malnutrition and malnutrition were 50.5%， 26.5% and 23.0%， respectively. The prevalence of sarcopenia was significantly different between three groups， and the prevalence of sarcopenia in malnutrition group was higher than that in the risk of malnutrition group and the normal nutrition group (P<0.05). The levels of albumin， prealbumin， hemoglobin， body mass index， skeletal muscle， appendicular skeletal muscle mass index， grip strength and stride speed were significantly different between three groups (P<0.05). Conclusions There is a high proportion of malnutrition risk and malnutrition in elderly patients. Patients with malnutrition were more likely to suffer from sarcopenia. Timely nutritional treatment is necessary.
2019 Vol. 6 (2): 225-229 [Abstract] ( 454 ) HTML PDF (498 KB)  ( 376 )
230 Immune enteral nutrition on advanced gastrointestinal cancer patients undergoing apatinib
CHANG Ge-yun
Objective Apatinib is currently the first effective oral anti-tumor angiogenesis drug for the treatment of patients with advanced chemotherapy-resistant gastric cancer. This study is to explore the effects of immune enteral nutrition treatment on the nutritional status and toxicity of advanced gastric cancer patients undergoing apatinib. Methods From January 2016 to September 2018，108 patients with gastric cancer selected from Aviation Gerneral Hospital were randomly divided into the treatment group and the control group. The observation group (n = 54) was treated with immune enteral nutritional support and apatinib， the control group (n = 54) was given normal diet direction and apatinib. Before and after 2 cycles， two groups were assessed and evaluated in terms of the nutritional status， toxicity reaction and nosocomial infection rate. Results Before treatment， the clinical data such as mean age， gender， types of cancer and nutritional index between the two groups were all no statistical significance (P>0.05). After treatment， the body mass index， albumin level and prealbumin level of observation group were all significantly better than those of the control group. The incidence of nosocomial infection in the observation group was significantly lower than in the control group (P<0.05). After two cycles of treatment， the body mass index， albumin level and prealbumin level of observation group were all higher than before (P<0.05). In contrast， the body mass index， hemoglobin， albumin and prealbumin level of control group were all lower than before (P<0.05).Regarding the adverse reactions of apatinib， the incidences of fatigue， myelosuppression and diarrhea were all significantly different(P<0.05). However， there was no statistical difference of efficiency between the two groups. Conclusions Providing enteral nutritional therapy to advanced gastric cancer patients undergoing antiangiogenic treatment can not only improve the nutrition status， but also alleviate the antiangiogenic-induced adverse reaction and the incidence of nosocomial infection.
2019 Vol. 6 (2): 230-235 [Abstract] ( 383 ) HTML PDF (565 KB)  ( 286 )
236 Ampelopsin induces cell growth inhibition in breast cancer cells by suppressing pyruvate kinase M2-dependent glycolysis
ZHOU Yong， ZHENG Jin-ying， XU Xiao-hua， JIN Xiao-ling
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.016
Objective To explore whether AMP， a flavonol mainly found in Ampelopsis grossedentata， induces cell growth inhibition by suppressing glycolysis through Akt-mTOR/PKM2 pathway in breast cancer cells. Methods After MCF-7 and MDA- MB-231 breast cancer cells treated with 20， 40， 60 and 80μmol/L AMP for 24h， cell viability was assessed by CCK-8 assay， glucose uptake assay was performed using 2-NBDG， lactate levels were measured using the colorimetric lactate assay kit and the protein expressions were assessed by Western blot. Results AMP treatment could inhibit cell viability in MCF-7 and MDA- MB-231 breast cancer cells in dose-dependent manners. The further experiments exhibited that AMP successfully blocked cell glycolysis by inhibiting the level of glucose uptake and the production of lactic acid， decreased the level of glycolysis-related proteins pyruvate kinase M2 (PKM2)， glucose transporter1 (GLUT1) and lactate dehydrogenase A (LDHA)， and also inactivated the Akt-mTOR pathway by down-regulation of p-Akt、p-mTOR、p-p70S6K expressions. However， Akt-mTOR pathway inducer IGF-1 treatment significantly attenuated AMP- induced above mentioned results. Conclusion AMP suppressed breast cancer cell growth and glycolysis through inhibiting Akt-mTOR/PKM2 pathway， and may provide a potential therapeutic target for breast cancer treatment.
2019 Vol. 6 (2): 236-241 [Abstract] ( 412 ) HTML PDF (1216 KB)  ( 291 )
242 Analysis of expression and its clinical significance of UBE2T in lung cancer based on GEO database
LI Wei， GUO Zi-xing， LI Yong-hong， LIU Xiao-ping， HUANG Jing-yu， HU Wei-dong， LI Sheng
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.017
Objective To investigate the expression of Ubiquitin-conjugating enzyme E2T(UBE2T) in lung cancer in the NCBI Gene Expression Omnibus (GEO) database and its relationship with clinicopathological characteristics and prognosis of lung cancer. Methods GEO datasets were collected and expression profile of UBE2T and clinicopathological information of lung cancer tissues were downloaded. The relationship between UBE2T expression and clinicopathological features (age， T stage， N stage， M stage， pathological type and recurrence) and prognosis of lung cancer were analyzed. Gene enrichment analysis (GSEA) was used to analyze genes regulated by UBE2T. Results The expression level of UBE2T in lung cancer tissues was 1.222±0.1214，higher than -1.645±0.0783 of normal bladder tissues， and the difference was statistically significant (P＜0.05). The expression of UBE2T in lung cancer tissues was related to T stage， N stage， pathological analysis and recurrence (P<0.05)， but not related to gender， age and M stage (P>0.05). The 5-year overall survival rate and 5-year disease-free survival rate of UBE2T high expression group were 32.672% and 27.513%， lower than 66.767% and 62.019% in the low-expression group， and the difference was statistically significant (P＜0.05). GSEA results showed that UBE2T highly expressed samples enriched MYC signaling pathway， DNA repair factor， mitotic spindle， G2M checkpoint， mTORC1 complex， E2F transcription factor and mitotic related gene sets. Conclusion UBE2T is highly expressed in lung cancer tissues and is related to many clinicopathological features of lung cancer. UBE2T could be considered as a potential marker and target in the diagnosis and treatment of lung cancer.
2019 Vol. 6 (2): 242-245 [Abstract] ( 677 ) HTML PDF (992 KB)  ( 397 )
246 Meta-analysis of the effects of glutamine on postoperative complications， immune function and nutritional status of colorectal cancer
JIN Xin， HU Ren-chong， TIAN Meng-xing， XU Xin-tian，LI Hong-xia， DAI Zhu， YANG Hui
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.018
Objective explore the effect of perioperative glutamine supplementation on postoperative complications， nutritional status and immune function of colorectal cancer. Methods All randomized controlled trials that met the inclusion criteria from the default time to October 2018 were retrieved from the following databases: Pubmed， Medline， Embase， Cochrane Library， Chinese biomedical literature database (CBM)， Chinese journal full text database (CNKI)， and Wanfang database. Meta-analysis was performed on the included studies after screening. Results A total of 22 articles were included， including 1，466 patients. Meta-analysis indicated perioperative supplement glutamine can prevent anastomotic fistula， shorten the length of hospital stay， adjust the immune function related indicators such as IgG， IgM， IgA， CD4， CD4/CD8， up-regulate nutrition-related biochemical indicators such as albumin， prealbumin and reduce the level of serum inflammatory factor TNF-α. However， there were also no significant differences between the two groups on postoperative incision infection and pulmonary infection complications. Conclusion Glutamine supplementation during the perioperative period of colorectal cancer plays a certain role in preventing anastomotic fistula， improving postoperative immune function and shortening hospitalization time， but there is insufficient evidence for preventing infectious complications and improving nutritional status.
2019 Vol. 6 (2): 246-255 [Abstract] ( 332 ) HTML PDF (14559 KB)  ( 66 )
256 Progress in the treatment of stage IIIa (N2) non-small cell lung cancer
YANG He-ling， JIANG Ou， LIU Yu， HE Yu， MA Cheng， HUANG Yan， MENG Fan-zhi
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.019
There is a significant difference in survival between IIIa (N2) stage NSCLC， and the choice of treatment methods is controversial. It is a heterogeneous group that requires multidisciplinary treatment. Surgery has evolved from the most important treatment to one of the main treatments. The future status may be further weakened； radiotherapy will play a more important role as the technical level progresses； the combination of chemotherapy and immunotherapy should receive more attention. The mechanism needs to be further elucidated； the application of targeted therapy and immunological checkpoint inhibitors in this type of patient deserves further study. Interaction between tumor cells and the host immune system in tumor immune microenvironment， through mutual role in the immune microenvironment immune escape and cause the recurrence and metastasis of tumors， the current through PD way antitumor immune therapy such as products have been applied to clinical and obtained certain achievements， the treatment principle mainly relies on the infiltrating into the tumors and the tumor microenvironment effect the function of T cells. According to the infiltration of immune cells around tumor cells (mainly T cells， etc.)， relevant studies have established the classification of new immunophenotypes， providing ideas and directions for the treatment and prognosis of patients， and the immune microenvironment is worth further discussion. Immunotherapy has become a new important treatment method after the traditional treatment methods such as surgery， radiotherapy and chemotherapy.
2019 Vol. 6 (2): 256-260 [Abstract] ( 468 ) HTML PDF (946 KB)  ( 336 )
261 The roles of energy balance factors on the prognosis of cancer survivors
LU Chen， LIU Ling-xiang
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.020
With advances in earlier detection and treatment， the number of cancer survivors living at least 5 years after diagnosis is increasing annually all around the world. The prognosis of cancer has become a ‘hot spot’ and the roles of energy balance factors as a novel method to improve the quality of life is drawing more and more attention. Energy balance means that the energy in the human body is relatively balanced during a certain period of time， that is， the ratio of the energy of input and output is equal to the rate of change of energy stored in the human body. Diet， weight， and physical activity are collectively referred to as energy balance factors by describing the relationship between energy consumed， expended and energy stored. There is prima facie evidence that obesity， inactivity， and low-quality diets can reduce survival in cancer patients， and lifestyle changes may also improve prognosis so this paper provides an overview of the many studies about energy balance factors on the prognosis of cancer survivors and provides lifestyle recommendations. Studies have shown that high-quality diets reduce mortality among survivors of breast cancer， prostate cancer and colorectal cancer， but the impact on head and neck cancer is still unknown； obesity at diagnosis increases mortality risk in patients with breast cancer and prostate cancer， and potentially in those with colorectal cancer； proper physical activity is good for prognosis in individuals diagnosed with the cancers of the breast and lung. Although further randomized controlled trials are needed， a healthy diet， a healthy weight， and a physically active lifestyle contribute to cancer prognosis. Energy balance related factors will hope to further improve the post-tumor treatment in the future.
2019 Vol. 6 (2): 261-265 [Abstract] ( 453 ) HTML PDF (862 KB)  ( 363 )
266 The relationship between monocarboxylate transporter and tumor metabolism
Chen Zhe-wen，Zhang Jie， Wang Zheng-ping，Song Meng-meng，Zhang Qi-yu， Miao Ming-yong，Shi Han-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.02.021
Monocarboxylate transporters (MCTs) are important transmembrane transporters responsible for monocarboxylate metabolites such as pyruvate， lactate， ketone bodies. They promote nutrient absorption of these substances and maintain the metabolic balance of cells. The expression of MCT in tumors is significantly up-regulated， which is closely related to glucose metabolism， lipid metabolism， energy metabolism and the formation of tumor microenvironment， and plays an essential role in maintaining the high glycolytic state of tumor cells. In some tumors， lactic acid is produced by glycolytic cells in the hypoxic region， excreted into the tumor microenvironment by MCT4， and then taken up by peripheral oxidized cells expressing MCT1， finally enters the TCA cycle and becomes a fuel for respiration. Pyruvate is also effluxed out of tumor cells by MCT1 and MCT2， while pyruvate in the tumor microenvironment promotes lung metastasis of breast cancer. At the same time， MCT promotes the formation of acidic tumor microenvironment， which is not only conducive to the growth， proliferation and metastasis of tumors， but also causes the death of normal cells around the tumor. The immunosuppression of tumors is also related to this. A number of studies have proved that the high expression of MCT1 and MCT4 is positively correlated with tumor malignancy and prognosis. Inhibition of MCT expression influences tumor growth， proliferation and metastasis， which provides potential therapeutic targets for targeted therapy. Currently MCT inhibitors such as CHC， AR-C155858 and AZD3965 are lack of selectivity for MCT subtypes， but have shown good therapeutic effects. While developing new MCT inhibitors， exploring strategies for joint application with traditional tumor therapies has a good clinical application prospect.
2019 Vol. 6 (2): 266-271 [Abstract] ( 644 ) HTML PDF (1043 KB)  ( 282 )
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