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2019 Vol. 6, No. 3
Published: 2019-09-10
 
273 The six-word rule of enhanced recovery for geriatric patients
YU Kai-ying, ZHANG Xiao-wei, PAN Lei， SHI Han-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.001
China is an aging society, whose elderly population is facing a high incidence of disease. Geriatric patients have decreased tolerance of illness and response to treatment due to the physiological decline accompany with aging. Therefore, it is ofgreat importance to enhance geriatric patients’ recovery in clinical practice. Enhancing recovery could be implied via various methods. Herein, the authors present, based on their clinical experience, six aspects that assist a patient’s rapid rehabilitation, including exercising respiratory function, continuous oxygen inhalation, rising physical activity, assuring sleep quality, limiting the volume of IV infusion, and nutrition therapy. In short, the six-word rule comprises “breathing, oxygenation, exercise, sleep, IV input-control, nutrition”. Despite building up the tolerance to stress and enhancing physical strength require a long-term effort, studies revealed that pre-rehabilitation before surgery or ERAS care during the perioperative period could significantly lower the complication rate and improve the treatment outcome. The six-word rule introduced in the current paper applies but not limited to geriatric patients and patients with or without surgical operation.
2019 Vol. 6 (3): 273-276 [Abstract] ( 463 ) HTML PDF (1297 KB)  ( 360 )
277 Molecular communication and mitochondrial metabolism
1YANG Zhen-peng， 1DENG Li， 1RAO Ben-qiang， 2PAN Guo-feng， 3JIN Shuai
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.002
Molecular communication is a short-distance communication technology using biochemical molecules as information carriers， which has unique advantages in metabolic disease research. Cell mitochondrial system contains abundant molecular information. Mitochondrial metabolism is also a process of many molecular interactions. Dynamic observation， vivification and visualization of mitochondrial metabolism by using molecular communication technology are of great significance to reveal the mechanism of mitochondrial diseases， diagnosis， prevention and treatment. In this paper， the basic concepts， architecture， the communication process and the transmission mechanism of molecular communication are summarized. The specific applications of molecular communication technology in mitochondrial metabolism research are introduced， such as mitochondrial energy metabolism， mitochondrial calcium concentration， mitochondrial spatial structure and mitochondrial-nuclear retrograde signal detection and analysis of molecular communication technology. The problems and prospects of molecular communication technology in mitochondrial metabolism research are helpful to deepen the understanding of molecular communication science and to understand the progress of molecular communication technology in mitochondrial metabolism research. Molecular communication provides a method of capturing mitochondrial metabolic information from molecular level to individual level. It can gradually realize quantitative detection of mitochondrial metabolism， and make the monitoring of mitochondrial metabolism develop from invasive， abstract to non-invasive， real-time， quantitative and visual. It will play an important role in the research and prevention of mitochondrial diseases.
2019 Vol. 6 (3): 277-282 [Abstract] ( 440 ) HTML PDF (2189 KB)  ( 341 )
283 Advances in anti-tumor effect of mannose
1，4 SONG Meng-meng，2CHEN Zhe-wen，3 LI Ye，1，4 SONG Chun-hua，5SHI Han-ping，6MIAO Ming-yong
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.003
“Warburg effect” is one of the important metabolic characteristics of tumor cells. Tumor cells still undergo glycolysis under the condition of sufficient oxygen， which is also known as “aerobic glycolysis”. Many studies have shown that cancer is a metabolic disease. Therefore， to explore the changes and mechanisms of tumor metabolism， as well as tumor metabolic regulation therapy targeting tumor metabolism， have become a focus of tumor research in recent years. At present， some treatment methods based on tumor metabolism， such as ketogenic therapy and high-dose vitamin C， have gradually attracted the attention of basic research and clinical research. Recently， it has been reported that mannose can inhibit tumor growth， increase the anti-cancer effect of adriamycin and prolong the survival period of tumor-bearing mice. It mainly interferes with glucose metabolism and enhances the anti-tumor effect of chemotherapy drugs cisplatin and adriamycin to promote tumor cell apoptosis. In addition， mannose still has the effect of regulating immunity balance. Mannose， as a  nutrient， is harmless to human health， and is expected to become an important nutrient for tumor metabolism regulation therapy， and can be combined with first-line tumor therapy (chemotherapy and radiotherapy) to improve the anti-tumor treatment effect， which has important clinical significance and application prospect.     
2019 Vol. 6 (3): 283-286 [Abstract] ( 610 ) HTML PDF (1061 KB)  ( 338 )
287 Current problems and thinkings on the cancer metabolic modulation therapy
SUN Xue-hua， ZHOU Fu-xiang
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.004
With advances in the research on cancer metabolic modulation therapy， it has been found that metabolic reprogramming of cancer cells with a single Warburg effect may not be representative of globally defined tumor metabolic reprogramming. At the same time， mitochondria play an important role in tumor metabolic reprogramming. Based on previous studies， we conclude that mitochondrial dysfunction can regulate tumor metabolic reprogramming through three modes: mitochondrial dysfunction-induced metabolic reprogramming， nuclear gene mutation-induced metabolic reprogramming， and mixed factors-induced metabolic reprogramming. Metabolic reprogramming of tumor cells is characterized by flexible metabolic plasticity due to differences in tumor genotype，tumor subtype， degree of differentiation， and changes of tumor microenvironment. Cancer cells can steal the metabolic wastes of tumor-related cells， and they are interdependent and interact with each other， showing the characteristics of metabolic symbiosis. In addition， cancer cells can also exhibit a stable  heterozygous metabolic phenotype which affects the biological behavior of the tumor. This review begins with the current knowledge of tumor glucose regulation therapy， involves the current research problems， and summarizes the effects of mitochondrial dysfunction on metabolic reprogramming. It focuses on the metabolic plasticity of cancer cells， the metabolic coupling between tumor cells and tumor-associated cells， and the  heterozygous metabolic phenotype of tumor cells. The effects of glycolysis and mitochondrial  oxidative phosphorylation on the complexity of tumor metabolism are discussed， and the corresponding countermeasures are put forward for the complex tumor glucose metabolism.
2019 Vol. 6 (3): 287-294 [Abstract] ( 524 ) HTML PDF (1570 KB)  ( 338 )
295 Metabolic reprogramming in liver cancer and its potential clinical implications
1HOU Yi-ran，1LI Bao-li， 2XING Jin-liang， 3LI Ji-bin
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.005
Liver cancer is one of the most common malignant tumors in China， which is characterized by high degree of malignancy， insidious onset and lack of specific markers for early diagnosis and treatment. The development of liver cancer is  its metabolic process. Similar to most other tumor cells， the metabolic process of liver cancer cells has undergone many significant changes compared to normal hepatocytes， such as abnormal activity of glycolysis， increased de novo synthesis of fatty acids and decreased oxidation， and accelerated glutamine catabolism. These abnormal changes in metabolism provide intermediate substances and energy for the rapid growth， proliferation and metastasis of liver cancer cells. At the same time， a variety of enzymes and signaling molecules involved in different metabolic processes also play an irreplaceable role in liver cancer. Therefore， the key metabolic enzymes and pathways that regulate the above metabolic processes are important targets for the diagnosis and treatment of liver cancer. In recent years， the reprogramming of liver cancer cells and its clinical application have made remarkable progress. In addition， the research for new markers has been the focus of liver cancer. This paper focuses on the abnormal changes of glucose， lipid， amino acid and nucleotide metabolism and its molecular mechanism and the potential clinical application value of metabolic marker molecules will be summarized and prospected.
2019 Vol. 6 (3): 295-300 [Abstract] ( 490 ) HTML PDF (459 KB)  ( 431 )
301 Interpretation of expert consensus for nutritional therapy pathway of malignant tumor in China—peripheral venous catheterization
1FAN Yue-ping， 2ZHANG Tian， 2QU Qian-nuo， 3SHI Han-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.006
Peripheral parenteral nutrition (PPN) is one of the methods of parenteral nutritional support treatment. PPN can be used for nutritional supplement in patients who cannot receive enteral nutrition treatment or intake insufficient enteral nutrition treatment， as well as for patients who cannot establish central venous pathways or patients who have  short term， low calorie or low nitrogen requirements. PPN has the advantages of quick and simple nutrient solution access， lower medical cost and fewer complications. Many clinical trials and researchers have confirmed that PPN is safe and effective for perioperative patients. The idea that parenteral nutrition with low osmotic pressure can be safely used for PPN has been widely accepted clinically. The addition of fat emulsions into  parenteral nutrition solution can lower the high osmolarity produced by amino acids， glucose and electrolytes， and reduce the incidence of thrombophlebitis. Meanwhile， PPN application time should be shorten to avoid long-term use. During using PPN， the nutrition support group should observe and monitor the site of puncture and infusion on a daily basis， so as to timely find the symptoms and signs of thrombophlebitis and timely deal with them.
2019 Vol. 6 (3): 301-304 [Abstract] ( 454 ) HTML PDF (470 KB)  ( 463 )
305 Application of individualized nutrition diagnosis and intervention in patients with advanced cancer
1YAO Ke-qing， 1WANG Su， 1CHEN Shuang， 1SUN Yan-teng， 1LIU Qing-yang， 1CHEN Tao，1LIU Xue-hui， 2CONG Ming-hua
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.007
To explore the application of individualized nutrition diagnosis and intervention based on cancer nutrition diagnosis and intervention system in patients with advanced cancer by chemotherapy. Methods  All patients admitted to the hospital from January to June 2019 were screened by nutrition risk screening 2002(NRS 2002). One hundred and two patients with nutritional risk (NRS 2002≥3) were screened， which were randomly divided into the control group (n=51) and the observation group (n=51).The patients in the control group were managed by the nutrition support team， while the patients in the observation group were treated by the cancer nutrition diagnosis and intervention system. The changes of nutritional status between the two groups  were compared before and after two cycles of chemotherapy， and the side effects of chemotherapy. Results  After two cycles of chemotherapy， the body weight， muscle mass and appendicular skeletal muscle index of the two groups remained stable， and there was no significant difference compared with  that before chemotherapy (P>0.05). In the control group， compared with those before chemotherapy， the levels of hemoglobin ［(99.17±12.54)g/L  vs (115.26±13.14)g/L］， albumin ［(34.20±2.33)g/L  vs (37.80±2.16)g/L］ and prealbumin ［(19.48±3.02)mg/dl  vs (26.14 ±3.21)mg/dl］ were significantly increased (P<0.05).Similarly， in the observation group， compared with before chemotherapy， the levels of hemoglobin ［(110.08±15.74)g/L  vs  (122.91±23.08)g/L］， albumin ［(37.20±3.18)g/L  vs  (42.01±5.73)g/L］ and prealbumin ［(24.13±2.56）mg/dl  vs  （29.14±3.74）mg/dl］ were significantly increased (P<0.05).In addition， there were no significant differences in bone marrow suppression (5.9%  vs 3.9%)， leukopenia (5.9%  vs  7.8%) and digestive tract reaction (15.7  vs  19.6%) between the two groups (P>0.05).Conclusion   Individualized nutrition diagnosis and intervention by cancer nutrition diagnosis and intervention system and nutrition support team can help patients with advanced cancer maintain their nutritional status during two cycles of chemotherapy and increase their tolerance to chemotherapy.
2019 Vol. 6 (3): 305-309 [Abstract] ( 408 ) HTML PDF (514 KB)  ( 377 )
310 Atg13 gene overexpression induces chemotherapy resistance in triple-negative breast cancer cells
1LIU Yong-bo，2，3DENG Li， 1GUO Yi-hui，1LI Yan-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.008
Objective  To explore the impact of gene 13(Atg13) on promoting chemotherapy resistance in triple-negative breast cancer (TNBC) cells. Methods  We developed a doxorubicin-resistant MDA-MB-231/Dox cell lines using intermittent application of doxorubicin (Dox). MDA-MB-231/Dox was determined by the drug-sensitive assay and the apoptosis assay (TUNEL staining).The expression of LC3A and LC3B in TNBC cells (MDA-MB-231 and MDA-MB-231/Dox) was detected by Western Blot (WB). The number of LC3B fluorescence spots in the cells was quantified by immunofluorescence. Recombinant plasmid sh-Atg13 was transfected into MDA-MB-231/Dox by liposome， then stable cells (referred to as MDA-MB-231/Dox+sh-Atg13) were obtained by puromycin screening (PM). The Atg13 expression level in MDA-MB-231/Dox+sh-Atg13 and empty plasmid MDA-MB-231/Dox+control plasmid by WB. Changes in autophagy activity were determined by the level of LC3A， LC3B expression and the number of LC3B fluorescent spots. Drug sensitivity of each cell line to Dox was also examined. Results  Dox-resistant TNBC cell line MDA-MB-231/Dox were successfully established in vitro. The results showed that the level of basal autophagy in drug-resistant cells was significantly higher than that in sensitive cells MDA-MB-231(P<0.05). After inhibiting the expression of Atg13 gene by recombinant interference plasmid sh-Atg13， the protein expression of autophagy marker LC3B in drug-resistant cells MDA-MB-231/Dox was significantly decreased (P<0.05)， the drug sensitivity of MDA-MB-231/Dox cells to Dox was increased (IC50 value was significant， P<0.05). Conclusion  In TNBC cell MDA-MB-231， Atg13 increased chemotherapy resistance by inducing autophagy were determined.
2019 Vol. 6 (3): 310-315 [Abstract] ( 375 ) HTML PDF (3142 KB)  ( 254 )
316 Relationship between uric acid and clinical features and prognosis of patients with advanced colon cancer
YUAN Xiao-xing
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.009
Objective  To investigate the relationship of uric acid and clinicopathological features and prognosis of patients with advanced colon cancer. Methods  The clinical data of 98 patients with stage IV colon cancer were collected and analyzed retrospectively. We analyzed the incidence of  hyperuricemia during the natural course of colon cancer patients， and its relationship with the gender， age， degree of differentiation， liver metastasis of these patients. Kaplan-Meier method and multivariate Cox regression model were used to analyze the effect of hyperuricemia on prognosis. Results  Among 98 cases of colon cancer patients， 50 (51%) cases were accompanied with hyperuricemia，those median was 488.5(416.3，579.0)μmol/L in male and 453.7(359.7，551.3)μmol/L in female。The incidence of hyperuricemia was marginally related to the gender， age and site (P>0.05) while significantly related to degree of differentiation and liver metastasis (OR=6.315，P<0.01;OR=3.659， P<0.05). The ORR of the patients without hyperuricemia was 70.5%， which is significantly higher than 28% in patients with hyperuricemia (OR=6.245， P<0.01). The median overall survival of the patients with hyperuricemia was 22 months (95%CI=20.915~27.085). It is significantly shorter than 36 months (95%CI=31.688~42.312) of patients without hyperuricemia (HR=4.803，95%CI=2.970~7.769，P<0.01). The results of Cox regression survival analysis showed that the incidence of hyperuricemia was independent factors of prognosis of patients with colon cancer (P<0.05). Conclusion  During the natural course of advanced colon cancer， the incidence of hyperuricemia was high. The incidence of hyperuricemia are substantially correlated with degree of differentiation，liver metastasis and ORR. The incidence of hyperuricemia is independent prognosis factors of patients with colon cancer.
2019 Vol. 6 (3): 316-319 [Abstract] ( 411 ) HTML PDF (618 KB)  ( 291 )
320 L-carnitine improves skeletal muscle cell atrophy of cancer cachexia by regulating lipid metabolism
1，2ZHU Ming-xing， 1WU Chang-peng， 3YIN Liang-yu，1LU Zong-liang， 1LI Na，1LIU Jie， 1GUO Jing， 1XU Hong-xia
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.010
Objective  To explore the underlying mechanisms of L-carnitine on improving cancer cachexia. Methods  100ng/ml TNF-α was used in murine myoblast cell-line C2C12 to induce cell atrophy. Cell model of cancer cachexia associated skeletal muscle loss was established. Differentiation status of skeletal muscle fiber treated by different doses of L-carnitine was observed under microscope after stained by crystal violet. Lipid metabolism related protein expressions in C2C12 were analyzed using Western Blot to explore the underlying mechanisms of L-carnitine on improving cancer cachexia. Results  100μg/ml and 1000μg/ml L-carnitine treatments induced differentiation of C2C12 and increased the diameter of skeletal muscle fiber (P<0.001). TNF-α group compared with the control group， the expression of CPT-I and PGC-1α decreased， while FOXO1， CD36 and PDK4 elevated. L-carnitine induced PGC1-α and CPT-I expressions but inhibited FOXO1 and CD36 expressions. L-carnitine had no effects on PDK4 expression. Conclusion   L-carnitine improves cancer associated cachexia and increases skeletal muscle protein via regulating lipid metabolism capacity.
2019 Vol. 6 (3): 320-325 [Abstract] ( 412 ) HTML PDF (2783 KB)  ( 331 )
326 Application of perioperative nutritional support in patients with meningioma
1XUE Tao， 1WANG Wei-hong， 2MA Hui，1ZHANG Na，1ZHANG Sheng-Jun， 1DU Xin-ying
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.011
Objective  To investigate the effect of perioperative nutritional therapy in patients with meningioma.  Methods   65 patients who underwent meningioma resection  from January 2017 to November 2018 were selected and randomly divided into two groups: observation group (n=32) and control group (n=33). To observe and compare the differences of postoperative fasting blood glucose， serum albumin， inflammatory index， hospital stay and hospitalization cost between the two groups. Results  The results of repeated analysis of variance  showed statistically significant differences in albumin and white blood cell count (P<0.05)， with an F value of 8.450 and 18.647. Pairwise comparison results showed that the two groups of fasting blood glucose， serum albumin， white blood cell count， along with the change of time were different. Fasting blood glucose on the third day and white blood cell count on the 3/5/8 day after operation were lower than those of the control group. The albumin level on the first day after the operation was higher than that of the control group (P<0.05). Compared to the control group and the observation group， postoperative hospitalization days (13.63±3.82) d vs (16.58± 6.60) d， and antibiotic cost (2，923± 562.83) yuan vs(431.37± 104.74) yuan， have statistically significant (P<0.05). Conclusion   Perioperative nutritional therapy plays a certain role in maintaining negative nitrogen balance in patients with meningioma， preventing inflammatory reaction and shortening hospital stay.
2019 Vol. 6 (3): 326-331 [Abstract] ( 346 ) HTML PDF (2112 KB)  ( 269 )
332 Nasojejunal nutrition therapy improves the efficacy and decreased adverse reactions of radiotherapy for esophageal cancer patients
CHENG Guo-wei， SUN Li， CHEN Ping， HE Xiang-ling， SU Dan， XI Heng-zhi， ZANG Ding-qi
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.012
Objective To evaluate the effects of different nutritional support methods on short-term efficacy and adverse reactions of patients with advanced esophageal cancer during radiotherapy. Methods  According to nutritional intervention， patients were divided into the experimental group and the control group. The experimental group （n=67） was given nasojejunal nutrition tube feeding， while the control group （n=67） was given dietary guidance， oral nutrition or parenteral nutrition. Short-term efficacy， incidence of adverse reactions and treatment completion were compared between the two groups， and nutrition-related adverse events were analyzed. Results The two sets of data were comparable and balanced. The effective rate of radiotherapy in the experimental group was higher than that in the control group， but there was no statistical difference （P>0.05）. The incidence of gastrointestinal bleeding grade 3 or above radioactive esophagitis in the experimental group was significantly lower than that in the control group （P<0.05）， but there was no difference in the incidence of grade 3 or above bone marrow suppression and grade 2 or above radioactive pneumonia （P>0.05）. The treatment completion rate of the experimental group was higher than that of the control group （P<0.05）. Weight loss at the end of radiotherapy and 1month after radiotherapy were significantly lower in the experimental group than those in the control group （P<0.05）. All patients in the experimental group were removed from the jejunal nutrition tube within 1month after the end of radiotherapy. 5.97% of the patients developed esophageal reflux， aspiration and aspiration pneumonia， without affecting the original treatment plan. Conclusion When patients with advanced esophageal cancer and high risk factors were treated with chest radiotherapy， nutritional support by tube feeding help to maintain body weight， reduce adverse reactions， and reduce treatment interruption.
2019 Vol. 6 (3): 332-336 [Abstract] ( 352 ) HTML PDF (548 KB)  ( 297 )
337 Influencing factors of quality of life in surgical patients with primary liver cancer
1LUO Xi， 2MA Di， 2YANG Yu-cheng， 2CHEN Yong-jun， 1CAO Wei-xin， 1SHI Yong-mei
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.013
Objective To explore the factors affecting the quality of life of surgical patients with primary hepatocellular carcinoma (PHC)， and to provide evidence for clinical treatment and life intervention. Methods  364 cases of primary liver cancer admitted to the liver and cholecystectomy of Shanghai Ruijin Hospital between January 1， 2017 and October 31， 2018 were investigated by questionnaires and EORTC QLQC30. The factors affecting the quality of life of patients with primary liver cancer were analyzed by multiple linear regression analysis. Results Univariate analysis showed that age， education level， marital status， nutritional status， income， payment method， Child-Pugh grading of liver function and other factors had significant impact on the quality of life of patients with primary liver cancer (P<0.05). But sex and treatment methods had no obvious effect on the quality of life of liver cancer patients. Multivariate linear regression analysis showed that the education level， economic income， nutritional status of patients were positively correlated with quality of life score， while age， Child-Pugh grade of liver function were negatively correlated with quality of life score (P<0.05). Conclusion There are many factors affecting the quality of life of patients with hepatocellular carcinoma. In the course of treatment， positive and targeted interventions can effectively improve the quality of life of patients.
2019 Vol. 6 (3): 337-341 [Abstract] ( 399 ) HTML PDF (586 KB)  ( 262 )
342 Analysis of nutritional status of hospitalized patients with type 2 diabetes mellitus
SHI Han-ping， LIANG Xiao-xiao
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.014
Objective To analyze the nutritional status of hospitalized patients with type 2 diabetes mellitus (T2DM). Methods  Using fixed-point continuous sampling， 512 cases of hospitalized patients with T2DM were screened for nutritional risk by nutritional risk screening 2002(NRS 2002)， and relevant biochemical indicators were collected to analyzed the relationship with gender， age， disease course and relevant biochemical indicators. The status of nutrition was determined by hospitalized patients’ body mass index (BMI)， with BMI<18.5 indicating malnutrition，24≤BMI<28 indicating overweight，and BMI≥28 indicating obesity. Results The incidence of nutritional risk in 512 hospitalized patients with T2DM was 18.0%， and the incidence of malnutrition， overweight， obesity were 2.5%， 35.9% and 8.6%， respectively. The incidence of nutrition risk was higher in men than that in women， but there was no statistical difference (P<0.05). The incidence of nutrition risk in ≥70 years hospitalized patients with T2DM was higher than that in two aged groups<60 years and 61～69 years (P<0.05). There was no difference in the incidence of nutrition risk in the course of disease (P<0.05). Compared with hospitalized patients with no nutrition risk diabetes， hospitalized patients with nutrition risk diabetes had higher HbA1c、ESR、Bun、SCr (P<0.05). With hospitalized T2DM with nutritional risk as the dependent variable， age， HbA1c、ESR、Bun、SCr as independent variables， multiariable Logistic regression analysis， the results showed that age and HbA1c are the related risk factors for nutrition risk of T2DM. Conclusion The nutritional status of T2DM is not optimistic; therefore it is necessary to strengthen nutrition risk screening， evaluation， intervention and health education.
2019 Vol. 6 (3): 342-345 [Abstract] ( 415 ) HTML PDF (392 KB)  ( 273 )
346 ABD bioactives alleviates chemotherapy-induced myelosuppression
1*LUO Min， 2*WU Xiao-jun， 2ZHANG Xin， 3DONG Guang， 4XIONG Li-long， 4WANG Peng-cheng， 1GAO Kui， 1YU Ping， 1HE Mei， 5DU Chi， 5JIANG Ou， 6SHI Han-ping
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.015
Objective To explore the effect of ABD bioactives on myelosuppression alleviation in lung cancer patients during chemotherapy. Methods  44 lung cancer patients who received chemotherapy were randomly divided into intervention group and control group. 22 lung patients in intervention group received ABD Bioactives for adjuvant therapy. 22 lung cancer patients were treated conventionally. The difference of myelosuppression was compared between the two groups. Results 43 patients completed chemotherapy as planned， and 1 patients of the control group terminated chemotherapy due to severe myelosuppression. Myelosuppression of intervention group was significantly alleviated (P<0.05). The incidence of myelosuppression of Ⅲ~Ⅳ was significantly lower (P<0.05)， and the inhibition of leukocytes， granulocytes and platelets was significantly alleviated (P<0.05，P<0.05，P<0.05) compared with the control group. The myelosuppression induced by paclitaxel +platinum-based agents， pemetrexed+ platinum-based agents was significantly alleviated (P<0.05，P<0.05，P<0.05，P<0.05) compared with the control group. Conclusion ABD Bioactives can alleviate chemotherapy-induced myelosuppression in lung cancer patients， especially reduce the incidence of Myelosuppression of Ⅲ~Ⅳ， increase the levels of leukocytes， granulocytes and platelets， reduce the toxicity and side effects of platinum-based agents， paclitaxel， antimetabolite.
2019 Vol. 6 (3): 346-350 [Abstract] ( 501 ) HTML PDF (511 KB)  ( 259 )
351 Changes and correlation analysis of serum leptin and adiponectin expression in patients with gastric and colorectal cancer
1MA Cui-cui， 2LI Yang， 3PANG Xiang-peng， 3LOU Ting-ting，1WANG Huan， 1GUO Rui-fang， 4LIU Ya-hang
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.016
Objective To determine the changes of serum leptin and adiponectin levels in patients with gastric cancer and colorectal cancer and their correlation with pathogenesis. Methods A total of 53 patients with gastric cancer， 48 patients with colorectal cancer， and 56 patients with non-tumor control were enrolled in the period from April 1， 2015 to January 31， 2016. Serum leptin and adiponectin were detected. Serum leptin and adiponectin expression in gastric cancer， colorectal cancer and non-tumor control groups were compared， and relative risk and correlation analysis were performed. Result After comparing the demographic characteristics and disease characteristics， the three groups of patients were found that have significant difference in gender (χ2=27.353， P=0.000)， age (χ2=9.953， P=0.007)， and education level (χ2=27.527， P=0.000)， the family history of the tumor (χ2=133.503， P=0.000). Compared with the non-tumor control group， the serum leptin expression level was increased in the gastric cancer group ［(6.02±1.83) vs (4.76±1.62)， P=0.013］， and the serum leptin expression level was increased in the colorectal cancer group ［(6.21±1.74) vs (4.76±1.62)， P=0.006］； serum adiponectin expression decreased in patients with gastric cancer ［(4.43±0.48) vs (4.90±0.39)， P=0.000］， and serum adiponectin expression decreased in patients with colorectal cancer ［(4.41±0.42) vs (4.90±0.39)， P=0.000］. The data were stratified by pathological classification， and there was no statistical difference between the three groups of high， medium and low differentiation. There were no statistical differences between the two groups in the early and middle-stage tumors. The serum leptin levels and adiponectin levels in the gastric cancer， colorectal cancer and non-tumor control groups were stratified by quartiles， and the relative risk analysis was performed. The serum leptin odds ratio (OR) of gastric cancer and colorectal cancer group OR values were 3.51 and 9.23， and the serum adiponectin OR values were 0.20 and 0.07. Conclusion Elevated serum leptin level is a risk factor for gastric cancer and colorectal cancer. Serum adiponectin level is a protective factor for gastric cancer and colorectal cancer， but the decrease of serum adiponectin level will increases gastric cancer and colorectal cancer’s risk of onset. Changes in serum leptin and adiponectin levels may be associated with the pathogenesis of gastric cancer and colorectal cancer.
2019 Vol. 6 (3): 351-356 [Abstract] ( 419 ) HTML PDF (522 KB)  ( 277 )
357 ONS improves nutritional status of esophageal cancer patients under radiotherapy treatment
ZHAO Xiang，WANG Wen-jing
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.017
Objective To investigate the effect of oral nutrition supplementation on the nutritional status of esophageal cancer patients under radiotherapy.Methods A total of 100 patients with esophageal cancer admitted to the oncology department of The 989 Hospital of Joint Logistic Support Force of People’s Liberation Army from September 2016 to April 2018 who were able to eat through mouth and were prepared to undergo linear accelerator conformal intensity modulated radiotherapy (60Gy/30F) with PG-SGA score ≥4 were selected as research object. Random number table method was used to divide the study group (ONS group) and the control group (routine liquid group).The changes of energy， protein intake， body weight and albumin， hemoglobin， lymphocyte count and other related nutritional indicators before and after radiotherapy were compared between the two groups. Results  Before radiotherapy， there were no statistically significant differences in age， weight， BMI， KPS score， PG-SGA score and nutrition-related indexes between the two groups (P>0.05). After radiotherapy， both groups lost weight， but the weight loss in the study group was no statistical significance (P>0.05). The levels of hemoglobin， lymphocyte， albumin and leukocyte in the control group all decreased significantly after radiotherapy (P<0.05). There was a significant decrease in lymphocytes in the study group after radiotherapy (P<0.05)， but no significant decrease in albumin， hemoglobin and leukocyte levels (P>0.05). Conclusion For patients with esophageal cancer who can eat through mouth but cannot meet nutritional requirements， ONS is beneficial to maintain energy and protein， maintaining body weight after radiotherapy， and improving nutritional status.
2019 Vol. 6 (3): 357-360 [Abstract] ( 429 ) HTML PDF (451 KB)  ( 341 )
361 Non-maligment bowel obstruction in the context of advanced cancer
ZHANG Xiao-wei， SHI Han-ping
DOI: 0.16689/j.cnki.cn11-9349/r.2019.03.018
Objective Malignant intestinal obstruction is a common complication of patients with advanced malignant tumors. Malignant intestinal obstruction was previously considered to be a terminal event. Previous studies have shown that the treatment of patients with malignant intestinal obstruction should be treated with end-stage care， focusing on individualized palliative care. Methods Two patients with non-maligment bowel obstruction in the context of advanced cancer were previously suffering from abdominal malignant tumors， both of which were gastric malignant tumors. The patient developed intestinal obstruction about 1 year after the standard treatment of the tumor， and the clinical manifestations were clear. One patient had recurrent symptoms between incomplete intestinal obstruction and complete intestinal obstruction for 3 months. One patient showed a complete intestinal obstruction with sudden onset. Both patients benefited from surgery-centered treatment， leading to improved quality of life， obtaining further treatment opportunities， and prolonged survival. Results The treatment of malignant bowel obstruction requires multidisciplinary collaboration. Its overall prognosis is poor. The two patients got benefit through surgery. From these two cases we learned that accurate preoperative assessment and improved perioperative treatment will give patients more opportunities. Conclusion  Doctors should not give up attempts to relieve obstruction of individual patients because of the poor overall prognosis of malignant intestinal obstruction. Through reasonable evaluation， standardized treatment， and active surgical exploration， patients can obtain good quality of life and continue palliative treatment opportunities.
2019 Vol. 6 (3): 361-364 [Abstract] ( 415 ) HTML PDF (1188 KB)  ( 307 )
365 Clinical intervention of coronary atherosclerosis in etiology， pathology and functional medicine
1CHENG， Richard Zhang， 2THOMAS Levy
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.019
Although the pathogenesis of CVD is very complicated and involves a variety of risk factors， it has been generally recognized and accepted in the literature that atherosclerosis is an inflammatory disease characterized by elevated oxidative stress. Sufficient basic research and preliminary clinical studies show that atherosclerosis is potentially reversible. Based on the review and analysis of decades of research， we propose a new theory of atherosclerosis development. Due to the continued and usually worsening presence of the increased oxidative stress， vitamin C deficiency， collagen synthesis deficiency and other pathogenic factors， this abnormal mechanism of arterial wall repair will not stop， which eventually leads to the formation of atherosclerosis plaque， resulting in arterial stenosis， occlusion and myocardial ischemia. Low carbohydrate diet promotes health， optimal and personalized nutrition and plays a leading role in the treatment and prevention of coronary atherosclerosis. In this paper， the mechanism of coronary heart disease is not limited to coronary heart disease due to the depletion of antioxidants (especially vitamin C) caused by the increase of oxidative pressure caused by toxin increase. This phenomenon can also be seen in osteoporosis. The dynamic changes among oxidative stress， antioxidants (vitamin C)， and collagen synthesis were regional.
2019 Vol. 6 (3): 365-369 [Abstract] ( 340 ) HTML PDF (966 KB)  ( 306 )
370 Exploration of a new mode of whole-process management of nutrition of gastrointestinal malignancy in Chinese and Western medicine
1CHEN Hai-tao， 2LU Yi， 3XU Chao， 4GUO Yong， 3，5YAO Qing-hua
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.020
The incidence of malnutrition in patients with malignant tumor is extremely high， especially in patients with gastrointestinal malignancy， which seriously affects the treatment and prognosis of cancer patients. Tumor nutrition therapy as another treatment method in addition to surgery， radio-chemotherapy， targeted therapy， immunotherapy should be used throughout the whole process of tumor treatment. Studies have shown that tumor nutrition therapy can not only shorten the length of hospitalization， increase the effective of anti-tumor therapy， reduce the adverse reactions caused by anti-tumor therapy， improve the quality of life， but also increase the overall survival of patients. Therefore， tumor nutrition therapy plays an irreplaceable role in the whole process of anti-tumor treatment. Traditional Chinese medicine(TCM) and Western medicine， as the two major medical systems in China， play an important role in the prevention and treatment of diseases. TCM believes that malnutrition is considered the category of “consumptive disease”. According to the theories in TCM of “reinforcing the vital energy and consolidating the constitution” and “reinforcing in deficiency condition”， TCM has certain curative effect in the prevention and treatment of tumor malnutrition. Based on the current research pattern of clinical interdisciplinary penetration， this paper comprehensively analyzes the tumor nutrition therapy from the perspective of TCM and Western medicine and lay a foundation for proposing a new model of tumor nutrition management in patients with gastrointestinal malignancy.
2019 Vol. 6 (3): 370-375 [Abstract] ( 396 ) HTML PDF (1622 KB)  ( 359 )
376 Acetyl-CoA metabolism and cancer metastasis
1，2GAO Chao， 1，2WANG Sheng-hao， 1，2ZHU Wen-wei， 1，2CHEN Jin-hong，1，2LU Ming， 1，2，3QIN Lun-xiu
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.021
Metastasis is an important hallmark of cancer and accounts for the majority of cancer-associated death. Cancer metastasis is regulated by multi-factors such as cancer cell itself and interactions between cancer cells and microenvironment. However， metastasis remains the most poorly understood component in cancer pathogenesis. Metabolic reprogramming is another important feature of cancer. Acetyl-CoA is a central metabolic intermediate， and plays a vital role in protein acetylation and lipid synthesis. Previous studies have shown that Acetyl-CoA metabolic alternation occurs in cancer progression， providing anabolic materials for the rapid proliferation of cancer cells. In recent years， several studies have reported close correlations between Acetyl-CoA metabolism alterations and tumor metastasis in several types of cancers， and have revealed the mechanisms underlying how Acetyl-CoA metabolic alterations promote cancer metastasis. This review will summarize recent progresses on the role Acetyl-CoA metabolic alteration in cancer metastasis from the following aspects: (1) brief introduction of the main metabolic pathways， key metabolic enzymes， and physiological roles of Acetyl-CoA metabolism;(2)Acetyl-CoA metabolism alterations regulate cancer metastasis by inducing epithelial-mesenchymal transition， cell adhesion and migration， and stemness of cancer cells;(3)future directions for the researches on the roles of Acetyl-CoA metabolism reprogramming in cancer metastasis.
2019 Vol. 6 (3): 376-381 [Abstract] ( 481 ) HTML PDF (1087 KB)  ( 477 )
382 Advances in drug therapy for cancer cachexia
WANG Chao-yun， DU Cheng， GUAN Xin， DU Xiao-wei， XU Zhu-xuan， ZHENG Zhen-dong
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.022
 When malignant tumors develop to the late stage， cancer cachexia (CC) is one of the most common complications. Its clinical symptoms are generally manifested as a decrease in muscle and bone mass， or a decrease in fat content， loss of appetite， and metabolic disorders， which lead to organ dysfunction. The study found that about one fifth of malignant tumor patients died from CC. The occurrence of CC has a serious impact on patients'lives， increasing treatment time， improving treatment cost， decreasing quality of life and reducing survival time. The pathogenesis of CC is complex. The known pathogenesis includes irreversible chronic inflammation induced by long-term stimulation of tumor tissue， the influence of inflammatory reaction on human metabolic balance， the inhibition of secretion of beneficial substances in central nervous system by inflammatory factors， and the reduction of appetite signals. At the present stage， some research results have been obtained on the pathogenesis of this disease. With the deepening of the research， we have a certain understanding of its therapeutic drugs. In view of its pathogenesis， the treatment of CC requires a variety of channels to work together， to give patients adequate nutrition and drug combination. This article from the current use of more appetite-stimulating drugs (progesterone， gastrin)， anti-inflammatory drugs (non-steroidal anti-inflammatory drugs， thalidomide， omega-3 fatty acids)， protein degradation inhibitors， metabolic regulators (androgen receptor regulators， beta-receptor blockers)analyzes the effect of the medication， and on the research progress of drug combination therapy is discussed.
2019 Vol. 6 (3): 382-385 [Abstract] ( 434 ) HTML PDF (428 KB)  ( 310 )
386 Review of family nutrition support research during the intermission of chemotherapy
1，2GENG Bi-zhu, 1ZHENG Jin
DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.022
Objective  To analyze the situation of family nutrition support in the intermittent period of chemotherapy, and to provide effective treatment for malnutrition in the intermittent period of chemotherapy for clinical staff. Methods   Literatures related to malnutrition, home nutrition support, home enteral nutrition, home parenteral nutrition, chemotherapy, traditional Chinese medicine diet were retrieved from CNKI, Wanfang, Pubmed and other Chinese and foreign databases in the recent 10 years. The overview of family nutrition, the methods of nutrition diagnosis for patients during chemotherapy intermission, the importance and content of nutrition education, and the prescription of family enteral nutrition support were reviewed. This paper summarizes the application of traditional Chinese medicine and traditional Chinese medicine in home nutrition support during the intermittent period of chemotherapy. Results  Nutritional screening and evaluation should be administrated to chemotherapy patients prior to home nutritional support. Nutrition group members should educate patients with nutritional risk, set up individualized nutritional support program, follow up regularly, and adjust the treatment plan in time accordingly. Oral nutrition supplementation is the first choice for home enteral nutrition. When oral nutrition supplementation cannot meet the nutritional needs or cannot be eaten orally, tube feeding is used. Homogeneous diet is the preferred way of home enteral nutrition. It is simple to operate and economical. Traditional Chinese medicine combined with chemotherapy can reduce toxicity and improve the nutritional status of patients. Conclusion  Good home nutritional support can improve the nutritional status and quality of life of chemotherapy patients, reduce treatment costs and save medical resources.
2019 Vol. 6 (3): 386-390 [Abstract] ( 422 ) HTML PDF (564 KB)  ( 435 )
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