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2019 Vol. 6, No. 4
Published: 2019-12-09
 
391 Nutritional status should be a basic vital sign
YU Kai-ying, LIU Li-hui, SHI Han-ping
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.001
The vital signs, including body temperature, pulse rate, respiration rate, and blood pressure, are subject to routine examinations on admission. Besides these four primary vital signs, nutritional status could be another essential vital sign. Nutritional status is closely associated with the therapeutic efficacy, clinical outcomes, complication rate, length of hospital stay, and medical costs. Nutritional imbalance, both over- and undernutrition, has an impact on several aspects such as physiology, psychology, society, and economy. Malnutrition not only has a personal effect on the patient, it also affects the family and even the next generation （s）. Therefore, nutritional status should be considered as a primary vital sign and recorded on the body temperature sheet on admission as a routine.
2019 Vol. 6 (4): 391-395 [Abstract] ( 522 ) HTML PDF (1181 KB)  ( 384 )
396 Research progress on pharmacological activities of bioactive constituents of red raspberry
ZHANG Hao-peng, LV Qiang, LIU Ming
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.002
The red raspberry is a rubus of the rose family. It contains varieties of nutrients as well as biological active substances, and is beneficial to human health. Therefore, its called the golden fruit. Long-term consumption of red raspberries can reduce the risk of many chronic diseases and play therapeutic roles. Oxidative stress and inflammatory reaction can be inhibited by red raspberry. And it can also regulate endothelial function. Thus, it retards or treats cardiovascular and cerebrovascular diseases. Inhibiting the activity of α-amylase and α-glucosidase, red raspberry can reduce the absorption of glucose after meals. Red raspberry contains a lot of dietary fiber and phenolic active substances, which can regulate lipid metabolism. Anti-inflammatory effects are mainly achieved by reducing LDL and lipid oxidation, DNA damage, the production ROS,  and NO, and increasing antioxidant enzyme activity. Antitumor mechanism mainly includes the scavenging ROS to prevent DNA oxidative damage, inhibiting the formation of DNA adduct, strengthening the DNA repair capacity, as well as regulating cell proliferation, apoptosis signaling pathways. This article reviews the pharmacological roles of red raspberry in heart cardiovascular and cerebrovascular diseases, diabetes, obesity, inflammation, tumor and other diseases.
2019 Vol. 6 (4): 396-400 [Abstract] ( 295 ) HTML PDF (646 KB)  ( 312 )
401 Regulation of metabolic reprogramming in the tumor microenvironment
YE Ling, ZHANG Hua-feng, LI Shi-ting
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.003
The occurrence, growth and metastasis of tumors are associated with its microenvironment. Cancer cells are surrounded by different kinds of cells, such as cancer-associated fibroblasts, immune cells. These cells establish a defensive microenvironment against tumors under the condition of hypoxia or nutrient deprivation. Under this complicated microenvironment, cancer cells reprogram their metabolic signatures to resist the killing function of immune cells. In this paper, we describe the regulation of metabolic reprogramming of cancer cells in two perspectives. On the one hand, in addition to traditional nutrients, tumor cells can acquire and utilize other nutrients in a special way to support rapid and unrestricted proliferation, such as lactic acid, ketone bodies, acetic acid, and branched-chain amino acids. These substances also play a vital role in the development of tumors. On the other hand, cancer cells can affect and regulate the surrounding immune cells and fibroblasts through metabolic changes under the lack of oxygen and nutrition. Cancer-associated fibroblasts can provide a variety of nutrients or growth factors to regulate the metabolism, meanwhile multiple metabolites from cancer cells inhibit the normal functions and the anti-tumor effects of surrounding immune cells. Ultimately, the microenvironment is transformed to be favorable for proliferation and development of tumors.
2019 Vol. 6 (4): 401-408 [Abstract] ( 410 ) HTML PDF (1808 KB)  ( 351 )
409 The anti-tumor mechanism of vitamin C
ZHAO Wen-zhi, SHI Han-ping
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.004
Vitamin C is an essential nutrient with important physiological function of anti-oxidant activity, anti-aging activity, preventing and treating iron deficiency anemia, being involved in synthesis of collagen, carnitine, catecholamines, and aminopeptide hormones, and biochemical reaction of hydroxylation of transcription factors. It has been nearly half a century since the beginning of researches of anti-tumor effect of vitamin C and the effect was challenged and verified repeatedly. At present, there are three main hypotheses about the anti-tumor mechanism of vitamin C, that is targeting redox imbalance to kill tumor cells, or targeting epigenetic regulators or targeting hypoxia-inducible factor 1（HIF-1） signaling to reduce the malignancy and enhance the sensitivity to treatment of cancer cells. In the mechanism of targeting redox imbalance, intracellular energy is exhausted due to the generation of H2O2 or the oxidation and reduction of the dehydroascorbic acid. In the mechanism of targeting epigenetic regulators, malignancy of the tumor cells is reducing through demethylation of DNA or histone catalyzed by enhancing activity of the related enzyme. In the mechanism of targeting HIF-1, malignancy of the tumor cells is reducing through inhibiting transcription of HIF-1 by enhancing activity of HIF hydroxylase. Its controversial about the efficiency and the prospect of vitamin C in treatment of cancer, which has led to the exploration of the question of drug sensitivity and dosage. Research on the anti-tumor effect of vitamin C is expected to provide a new way for the treatment of cancer.
2019 Vol. 6 (4): 409-414 [Abstract] ( 374 ) HTML PDF (1447 KB)  ( 445 )
415 Perioperative nutritional support for patients with gastrointestinal cancer
GENG Shi-tao, WANG Kun-hua
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.005
At present, the incidence rate of gastrointestinal malignant tumor is increasing year by year, and its nutritional risks and malnutrition are more common. Although malnutrition has been proved to be related to the clinical outcomes of malnutrition, the implementation of nutritional support in China is still not ideal, especially during perioperative period, patients often suffer from malnutrition, resulting in complications such as postoperative infection, delayed wound healing, and even increased mortality, which seriously affects postoperative recovery. Therefore, nutritional therapy is particularly important in the perioperative period of gastrointestinal malignant tumors. With the development of enhanced recovery after surgery （ERAS）, the management of perioperative nutrition is more refined, especially for patients with gastrointestinal malignant tumors. Individualized nutritional therapy should be formulated for different patients to maintain a good nutritional status during the perioperative period, which can improve the nutritional status of patients, maintain the effective metabolism and immune function of the body, improve the tolerance of patients to surgery, reduce stress, thus reducing complications, accelerating the rehabilitation of patients and improving prognosis. This article mainly reviews the nutritional status and influence of patients with gastrointestinal malignant tumors, preoperative nutritional risk screening and assessment, preoperative and postoperative nutritional support and selection of nutritional preparations, so as to illustrate that perioperative nutritional support is one of the key factors for treatment of gastrointestinal malignant tumors.
2019 Vol. 6 (4): 415-420 [Abstract] ( 401 ) HTML PDF (1249 KB)  ( 260 )
421 Integrated treatment of malignant bowel obstruction
SHI Han-ping, CHEN Yong-bing, RAO Ben-qiang, WANG Kun-hua, CONG Ming-hua, LI Su-yi, CHEN Jun-qiang, BA Yi, SHU Yong-qian, SHEN lin, LI Wei, CHEN Zi-hua, JIANG Zhi-wei, LIU Ming, YU Shi-ying； Chinese S
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.006
Malignant bowel obstruction is a type of intestinal obstruction caused by a malignant tumor, most commonly seen in ovarian, gastric, and colorectal tumors. The pathophysiology of MBO is both similar and significantly different from that of intestinal obstruction caused by benign diseases. Despite the poor overall prognosis, MBO is not an incurable disease. The treatment of MBO is an integrated therapy that includes the following 11 aspects: inhibiting secretion, stopping vomiting, suppressing inflammation, controlling pain, fighting tumors, fluid management, promoting drainage, improving body energy, decompression and drainage, improving nutrition, and recanalization of intestinal cavities. MBO currently does not have a golden rule for all patients, nor does it have a master key that can solve all problems with certainty. The ideal MBO treatment can only be a comprehensive treatment on an individual basis. To form a cross major multi-disciplinary team of MBO diagnosis and treatment, formulate balance the ideal and the reality of MBO diagnostic standard, in order to solve the main contradiction, improve the quality of life as the guidance of treatment goals, fully listen to the opinions of the patient and family, and positive and effective comprehensive treatment can significantly improve the quality of life in patients with tumor and prolong survival time.
2019 Vol. 6 (4): 421-426 [Abstract] ( 453 ) HTML PDF (785 KB)  ( 399 )
436 Changes of nutritional status in hematological patients before and after haploid hematopoietic stem cell transplantation
JIA Yan-xue, TAN Ye-hui, GAO Su-jun, LI Wei, PENG Yi
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.009
ObjectiveTo explore the nutritional status of patients underwent haploid hematopoietic stem cell transplantation （HSCT） before and after transplantation, and to provide evidence for clinical nutritional intervention among post transplantation patients.  Methods Forty-seven patients with hematological diseases received haploidentical allo-HSCT from July 2015 to June 2017 in the First Hospital of Jilin University were enrolled in present study. The patient-generated subjective global assessment （PG-SGA） and human component analysis were assessed before transplantation and 30, 90,180 days after transplantation respectively. ResultsThe body weight, body mass index （BMI）, fat-free mass, peripheral diameter of the left leg and mid-arm circumference decreased significantly at 30 days after transplantation, while fat mass increased but showed no statistical significance. Some indexes began to recover at 180 days after transplantation, but still lower than those before transplantation （all P<0.05）. According to the PG-SGA evaluation, malnutrition was as high as 95.56% in patients 30 days after transplantation, and recovered at 180 days after transplantation but still higher than those before transplantation （P<0.05）. In the early stage of transplantation, there were differences in weight and fat-free mass changes between men and women （P<0.05）. In particular, the proportion of weight loss in men at 30 days after transplantation was much higher than that in women, and men were more likely to have nutritional problems than women. ConclusionMalnutrition may occur in all patients after haploidentical allo-HSCT, and the nutritional assessment of the patients was more accurate and comprehensive by PG-SGA and human composition analysis.
2019 Vol. 6 (4): 436-441 [Abstract] ( 304 ) HTML PDF (545 KB)  ( 241 )
442 A cross-sectional study on nutritional risk and malnutrition of hospitalized patients with malignant tumors in radiotherapy center
FENG Chang-yan, HUANG Qing-qing, YU Hui-qing
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.010
ObjectiveTo investigate the prevalence of nutrition risk and malnutrition in cancer patients hospitalized for radiotherapy.  Methods We involved 330 patients with malignant tumors who were admitted to the radiotherapy center from August to October 2017 in Chongqing University Cancer Hospital. The nutrition risk was evaluated by the nutritional risk screening 2002 （NRS 2002）,the nutritional status was assessed with the patient-generated subjective global assessment （PG-SGA） questionnaire, the Karnofsky performance status （KPS）was used to evaluate the physical status. Physical indexes and laboratory examination results were recorded within 48 hours after admission. ResultsA total of 330 patients completed the nutritional survey. There were 227 males and 103 females, accounting for 68% and 31.2%, respectively. The mean age was 54.0±11.4 years old. 28.8% of the patients had nutritional risk （score≥3）,according to the PG-SGA score, 52.7% had the malnutrition （PG-SGA score≥4）. Among different cancers, patients with nasopharyngeal cancer had the highest prevalence of nutritional risk （29.3%）, the nutritional risk was 28.1%,18.1% and 15.2%, respectively, for patients with lung cancer, oral cancer and esophageal cancer who intending to accept radiotherapy. There was  a negative correlation between BMI and PG-SGA score, a positive correlation between the NRS 2002 score and the PG-SGA score. Age （≥65 years）, albumin （<40g/L）, prealbumin （<150g/L）, Karnofsky （<80） are the risk factors of nutritional risk and severe malnutrition （P<0.05）. ConclusionThe prevalence of nutritional risk in patients with radiotherapy was medium, but the prevalence of malnutrition in patients with radiotherapy was high. Nutrition management of the patients was very necessary for cancer patients receiving radiotherapy. In clinical practice, combined with the nutritional status of patients, PG-SGA score can be used as a reference standard for nutritional intervention.
2019 Vol. 6 (4): 442-446 [Abstract] ( 354 ) HTML PDF (477 KB)  ( 270 )
447 Two nutrition screening scales to evaluate the consistency of assessing malnutrition in elderly hospitalized patients in bed
SHEN Han, SUN Jin-hua, HU Jie
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.011
ObjectiveTo study the consistency of NRS 2002 and MNA-SF nutritional screening scales in assessing the risk of malnutrition in elderly clinical bed patients, and  to provide a basis for guiding nutritional intervention in elderly bedridden patients.  Methods Using NRS 2002 and MNA-SF nutritional screening tools to evaluate the nutritional status of 120 patients within 24 hours of admission. The results were compared with the nutritional indicators obtained by anthropometric and biochemical tests. Kappa analysis was used to test the consistency of the two nutritional evaluation methods in evaluating malnutrition. ResultsThe incidence of malnutrition in the NRS 2002 was 68.3%, and the MNA-SF was 63.3%. The risk of malnutrition increased with the age increasing, the difference was statistically significant （P<0.05）； Hb, TP, PA, and TLC values decreased accordingly within the occurred of malnutrition. Assessing the consistency rate of malnutrition in elderly bedridden patients was 90%（108/120） with two nutritional evaluation tools of NRS 2002 and MNA-SF, the value of Kappa was 0.778,and the value of 95% CI was 0.655～0.890,P<0.001.ConclusionNRS 2002 and MNA-SF, two nutrition screening scales , have a high consistent rate of malnutrition in elderly bed patients. Both of them can be used to evaluate malnutrition in elderly bed patients on admission, providing a basis for early clinical nutrition treatment.
2019 Vol. 6 (4): 447-450 [Abstract] ( 379 ) HTML PDF (415 KB)  ( 241 )
451 Study on the correlation between low phase angle and nutritional risk and hospitalization time in patients with malignant tumor
SONG Shi-ming, DU Hong-zhen, LI Zeng-ning
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.012
ObjectiveTo explore the association between phase angle （PA） and nutritional risk and hospital length of stay in patients with malignant tumors.    Methods We selected 259 patients with malignant tumors who were treated at the First Hospital of Hebei Medical University from October 2017 to September 2018  and used bioelectrical impedance analysis （BIA） for body composition testing to them. We chose nutritional risk screening 2002 （NRS 2002） for nutritional risk screening and patient-generated subjective global assessment （PG-SGA） for nutritional risk assessment to patients with malignant tumors, while collecting patients serum albumin （ALB） and hospitalization time. ResultsWe found that the BMI, ICW, FFM, SMM, BCM and protein of patients with malignant tumors in the normal PA group are higher than those in the low PA group （P<0.05）. The ICW, FFM, SMM, BCM and protein of male patients with malignant tumors in normal PA group and low PA group are higher than those in females （P<0.05）. The PA have an obviously negative correlation with NRS 2002 （r=－0.346，P<0.05） and PG-SGA （r=－0.393，P＜0.05）, meanwhile PA have a positive correlation with serum albumin （r=0.363，P<0.05） in evidence. Compared with the patients with malignant tumors in normal PA group, the patients in the low PA group are more likely to have nutritional risk. We calculate a serious of odds ratio （OR） and the results show that patients with malignant tumors who have nutritional risk （OR=3.7,95%CI=1.8~7.7） in the malnutrition group evaluated by NRS 2002 score, while moderate nutritional risk （OR=4.5, 95% CI=2.1~9.4） and severe nutritional risk （OR=12.6, 95% CI=5.1~31.3） by PG-SGA, grouped by serum albumin shows that serum albumin<40g/L （OR=3.7, 95% CI=2.1~6.4）. Compared with the normal PA group patients, the low PA group patients have a longer hospital stay, and the hospitalization time is greater than or equal to 14 days （OR=1.9, 95% CI=1.0~3.3） （P<0.05）. ConclusionLow PA is closely related to nutritional risk and hospital length of stay in patients with malignant tumors. Compared with normal PA patients, patients with low PA have higher nutritional risk and longer hospital length of stay. Therefore, to get PA of malignant tumor patients is helpful to quickly judge whether there is nutritional risk in them, which provides an objective basis for the implementation of nutritional intervention in time, and is conducive to disease control and improvement of patients.
2019 Vol. 6 (4): 451-456 [Abstract] ( 299 ) HTML PDF (1039 KB)  ( 319 )
457 The correlation between handgrip strength, inflammatory factors and patient-generated subjective global assessment score in preoperative patients with gastric cancer
1PENG Xiao-hui, 2XIONG Ling, 1WU Qi, 1YUAN Hui-hua, 1SUN Li
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.013
ObjectiveTo assess the nutritional status  and  analyze the correlation among objective indicators of anthropometric, blood biochemistry and inflammatory factors.  Methods 150 patients with simple gastric cancer hospitalized in the first department of abdomen surgy of Jianxi tumor hospital   from June 2017 to February 2018 were consecutively enrolled in this study. The nutritional status was assessed by patient-generated subjective global assessment （PG-SGA）in their first 24 hours in hospital.  The blood routine, blood biochemistry and inflammatory factors were detected. The height, weight, BMI, dominant handgrip strength and Karnofsky  performance status （KPS） were measured.  Pearson correlation and multivariate stepwise logistic regression analyses were used to analyze the related factors of nutritional status. ResultsFor the 150 patients with gastric cancer, there were 29 patients （19.33%） with well-nourished （0~1 point）, 39 patients （26.00%） with  suspected or mild malnutrition  （2~3 points）, 60 patients （40.00%） with moderate malnutrition （4~8 points） and 22 patients （14.67%） with severe malnutrition （≥9 points）. The height, weight, BMI, Hb, ALB, TG and dominant handgrip strength of patients in the malnutrition group （≥2 points） were significantly lower than those in the well-nourished group （0~1 point）, while the age, interleukin 2 （IL-2） and TNF-α levels were significantly higher than those in the well-nourished group （P<0.05）. Pearsons correlation analyses showed that  PG-SGA score was positively correlated with age （r=0.242）, IL-2 （r=0.284）,TNF-α （r=0.230） and negative correlated with BMI  （r=-0.310）,  KPS （r=-0.463）,  Hb （r=-0.233）,  ALB （r=-0.267） and dominant handgrip strength （r=-0.490） （P<0.05）.  Logistic stepwise regression analysis showed that age （OR=1.122）,  IL-2 （OR=1.010）,  TNF-α level （OR=1.139） and dominant handgrip strength （OR=0.832） were independent risk factors for malnutrition in gastric cancer patients before surgery. ConclusionThe incidence of preoperative malnutrition in patients with simple gastric cancer is relatively high, and their nutritional status can be monitored and evaluated by PG-SGA combined with objective indicators such as anthropometric measurements and inflammatory factors.
2019 Vol. 6 (4): 457-461 [Abstract] ( 349 ) HTML PDF (437 KB)  ( 245 )
462 Effect of  oral supplement  of β-hydroxy-β-methylbutyric acid on elderly patients with hip fracture
1ZUO Dan,2HUANG Biao,3LUO Chun-li,4ZHONG Lan
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.014
ObjectiveTo investigate the clinical efficacy of β-hydroxy-β-methylbutyrate acid in the treatment of muscular dystrophy in elderly patients with hip fracture.  Methods  From January 2018 to March 2019, the elderly patients with hip fracture who met the inclusion criteria were randomly divided into experimental group （n=30） and control group （n=28）. The control group was given conventional nutrition treatment, and the experimental group was treated with HMB on the basis of the control group. The weight, total protein, albumin, creatinine, grip strength, appendant skeletal muscle mass （ASMM）, the number of cases of pulmonary infection and the number of cases with Barthel index>40 were monitored and compared between the two groups at three time points （0, 3, 6 weeks）. ResultsThe body weight, total protein, albumin and creatinine of the patients in the experimental group increased significantly （P<0.05）. The ASMM of experimental group and control group decreased, but the difference was statistically significant （P<0.05）. There was no significant difference in grip strength （P>0.05）. The incidence of pulmonary infection in the control group was significantly higher than that in the experimental group （P<0.05）. The number of people whose Barthel index was more than 40 points was significantly higher than that of the control group （P<0.05）. ConclusionThrough the clinical study of HMB in the treatment of myopenia in elderly patients with hip fracture, it has obvious effects in inhibiting muscle and protein decomposition, increasing lean muscle and improving malnutrition status of patients. The incidence of pulmonary infection is relatively small, which can reduce the risk of death of patients, promote their rehabilitation and enhance their self-care ability to a certain extent. Prevention and reduction of muscle loss in hospitalized patients is one of the treatment factors clinicians should consider, so HMB should be better applied in the field of nutrition therapy. Whether HMB is effective for other diseases, such as tumors, liver transplantation and so on, still needs a lot of clinical experiments and evaluation methods to further study its clinical effect.
2019 Vol. 6 (4): 462-467 [Abstract] ( 305 ) HTML PDF (824 KB)  ( 239 )
468 Effect of standardized nutrition management on nutritional status of patients with head and neck cancer radiotherapy
LI Hua-chun，JIANG Qing-hua，ZHAO Ji-li，YANG Rui，ZHANG Dan
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.015
ObjectiveTo explore the effect of standardized nutrition management on nutritional status of patients with head and neck cancer radiotherapy. Methods From January 2016 to October 2017, the clinical data of 68 patients with head and neck cancer radiotherapy were collected in Radiation Oncology Department of Sichuan  Provincial  Cancer Hospital. According to the random digital table methods, patients were divided into the control group （34 cases） and the observation group （34 cases） with routine nutrition management and standardized nutrition management respectively. Changes in body weight, albumin, total lymphocyte count, hemoglobin and serum prealbumin during treatment were compared between the two groups. ResultsThe body weight of the observation group measured before radiotherapy, 4 weeks of radiotherapy and after the end of radiotherapy were （62.9±3.5）kg,（60.9±2.5）kg and （60.2±1.4）kg, with statistically significant between groups （F=9.79, P<0.001； Ftime=23.71, P<0.001； Finteraction=16.69, P<0.001）,the weight in the control group was （62.4±3.6）kg,（58.9±2.4）kg and （56.2±1.2）kg, The difference was statistically significant （between groups F=47.73, P<0.001； Ftime=114.38, P<0.001； Finteraction=88.75, P<0.001）,the weight loss in the observation group was significantly lower than that of the control group （P<0.05）.Before treatment, the contents of albumin, prealbumin, total lymphocyte count and hemoglobin in the observation group and the control group were （44.2±3.4）g/L,（280.1±58.5）mg/L,（1.86±0.66）×109/L,（129.8±14.1）g/L and （43.6±3.6）g/L,（273.7±49.4）mg/L,（1.89±0.84）×109/L,（140.0±12.6）g/L. After 4 weeks of radiotherapy and at the end of radiotherapy, each index in both groups decreased, the decrease of blood indexes in the observation group was also lower than that in the control group （P<0.05）. During the treatment,the incidence of adverse reactions,such as radioactive stomatitis and radioactive dermatitis in the observation group was 5.88% and 2.94%,which was significantly lower than that of the control group（17.65% and 14.71%） （P<0.05）. Conclusion Standardized nutritional intervention plays a significant role in the comprehensive treatment of locally advanced nasopharyngeal carcinoma. It is of great significance for improving the prognosis and improving the quality of life.
2019 Vol. 6 (4): 468-471 [Abstract] ( 315 ) HTML PDF (420 KB)  ( 269 )
472 Evaluation and application effect of nutritional intervention in patients with gastric cancer based on  PG-SGA
1SHAO Jian, 1ZHAO Qi-hua, 1ZHOU Hang, 2MAO Shi-chen
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.016
ObjectiveTo evaluate the effect of nutritional intervention on gastric cancer  patients based on PG-SGA rating scale. MethodsA total of 125 patients with gastric cancer were admitted to Subei Peoples Hospital of Jiangsu province were selected from October 2016 to October 2018. PG-SGA was used for nutritional assessment, and PG-SGA scores of patients with different ages, genders and body mass index were analyzed. Patients of grade B （4-8 scores） and grade C in the rating scale were randomly divided into the nutritional intervention group or the control group by simple random grouping. Patients in the nutritional intervention group were given nutritional education + nutritional intervention, while patients in the control group were given only nutritional education. The energy intake,  protein level in the body and red blood cell count and other nutritional indexes of the patients in the two groups were compared on the first and third week after admission. ResultsPG-SGA scores of patients with different ages and genders were compared between the two groups, and the differences were not statistically significant （P>0.05）. When comparing the BMIs and PG-SGA scores, significant differences were found in patients with 4-8 scores or ≥9 scores （P<0.05）.  The daily energy and protein intake in the nutritional intervention group was higher than that in the control group from week 1-3. The weight change （loss） in the control group was higher than that in the intervention group at week 3. The levels of albumin, total protein and hemoglobin in the intervention group were higher than that in the control group. The red blood cell count was higher than that in the control group. All above differences were statistically significant （P<0.05）. ConclusionPG-SGA assessment scale can reflect the nutritional status of patients with malignant tumor of the stomach, nutritional intervention can improve the nutritional status of patients with malignant tumor of the stomach.
2019 Vol. 6 (4): 472-476 [Abstract] ( 396 ) HTML PDF (492 KB)  ( 252 )
477 Study on the clinical effect of Reyanbao on local pain caused by intravenous infusion drugs
1ZHANG Hai-jing, 2SHENG Wei-xuan,1LIU Jin-xia,2GUAN Lei
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.017
Objective To investigate the clinical effect of Reyanbao on local pain caused by intravenous infusion drugs.  Methods 76 patients with local pain caused by drugs during intravenous infusion were selected and randomly divided into 2 groups （38 patients each）: the experimental group （Reyanbao group） and the control group （hot water bag group）. VAS scores of patients in the experimental group and the control group before and after treatment were recorded. ResultsThere was a statistical difference in VAS scores between the experimental group and the control group at T2 and T3（P<0.05）. VAS scores of the experimental group decreased significantly at T1, T2 and T3（P<0.05）. VAS scores of the control group decreased significantly at T1, T2 and T3（P<0.05）. There were statistically significant differences in patient satisfaction scores between the experimental group and the control group（P<0.05）. In terms of the survey of patients treatment satisfaction, the treatment satisfaction of the experimental group was significantly higher than that of the control group （P<0.05）.There were no significant differences in the incidence of adverse events between the two groups （P>0.05）.ConclusionReyanbao has a good analgesic effect on local pain caused by intravenous infusion drugs.
2019 Vol. 6 (4): 477-481 [Abstract] ( 358 ) HTML PDF (1066 KB)  ( 228 )
482 Correlation between nutritional status and quality of life during intensity-modulated radiotherapy in cancer patients
LIANG Lan-qing, LUO Yan-rong, WANG Qian-qian, MA Lin, QU Bao-lin, LIU Fang
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.018
Objective To investigate the correlation between nutritional status and quality of life in esophageal tumors and head and neck tumors during intensity-modulated radiotherapy.  Methods The cancer patients who received radiotherapy from November 2018 to May 2019 were selected for the study. NRS 2002 and PG-SGA were used to evaluate the nutrition of the patients during radiotherapy, and EORTC QLQ-C30 was used to evaluate the quality of life, and the correlation between them was analyzed. ResultsA total of 41 patients were enrolled, including 23 cases of esophageal cancer and 18 cases of head and neck cancer. 35 cases （85.36%） lost weight after radiotherapy, of which 19 cases （46.34%） lost ≥ 5% body weight. There were 2 patients with weight loss>10%, accounting for 4.88%, and the average weight loss was 3.6kg. During radiotherapy, there were 31 patients with myelosuppression, 15 patients with hypoalbuminemia and 24 patients with electrolyte disorder. After radiotherapy, The scores of general health status and physical function of patients were lower than those before radiotherapy （P<0.05）. The scores of pain, fatigue and loss of appetite were higher than those before radiotherapy （P<0.05）. General health status, physical function, pain and loss of appetite were significantly correlated with nutritional status （P<0.05）, while social function, emotional function, shortness of breath, constipation showed no significant correlation with nutritional status （P>0.05）. ConclusionThe nutritional status of cancer patients during radiotherapy is correlated with their quality of life. Attention should be paid to the nutritional evaluation and intervention during radiotherapy, in order to improve the quality of life in terms of physical function, pain and appetite and efficacy of cancer patients. 
2019 Vol. 6 (4): 482-487 [Abstract] ( 408 ) HTML PDF (679 KB)  ( 237 )
488 Advances in intestinal microecology and gastrointestinal cancer
ZHU Ya-ping, GUO Heng-zhao
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.019
The human microecosystem exists in the gastrointestinal tract, oral cavity, urogenital tract, respiratory tract, skin, and other parts of bodies, which is the most important and complex in the intestine. Intestinal microecology is involved in the development of the body, immune regulation, endocrine metabolism and other functions, and also affected by age, diet, antibiotics, psychological pressure, stress and other factors. The imbalance of intestinal microecology may cause many diseases, including skin diseases, obesity, infectious diseases, cardiovascular and cerebrovascular diseases and autoimmune diseases. With the development of intestinal microecology and gastrointestinal diseases, more and more scholars have found that the development of gastrointestinal tumors are significantly related to intestinal flora imbalance. The imbalance of intestinal flora directly or indirectly affects the development of tumor through the direct contact between microorganism and tumor, the regulation of body immunity, the production of bacterial metabolites and other mechanisms. Additionally, recent studies showed that intestinal microecology is closely related to the efficacy of various immunosuppressive checkpoint inhibitors, such as anti-programmed cell death protein-1 antibody, anti-programmed cell death protein ligand-1 antibody and anti-cytotoxic T lymphocyte associated antigen-4 antibody, which may be a potential biomarker to predict the efficacy of tumor immunotherapy. The paper summarizes the function of intestinal microecology and its role in the development of gastrointestinal cancer, hoping to provide reference for the future research focus and development direction.
2019 Vol. 6 (4): 488-493 [Abstract] ( 396 ) HTML PDF (508 KB)  ( 301 )
494 Research progress of CT relevant parameters in patients with gastrointestinal cancers
1LI Yi, 2ZHOU Fu-xiang, 1LI Qin-yang, 1 HU Ke, 1LIU Xian-hao, 1XU Yi-jun, 1,3YU Chang-hua
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.020
The degeneration of skeletal muscle is closely related to clinical outcomes of patients with carcinomas. CT is one of the commonly used diagnostic tools for patients with cancers, with high resolutions for skeletal muscles. The CT relevant parameters-SMD （skeletal muscle density） and SMI （skeletal muscle index）-reflect the quality （myosteatosis） and quantity （sarcopenia） for skeletal muscle. In this article, we collected literatures home and abroad through “pubmed and CNKI” to explore the clinical values of SMD and SMI among patients with gastrointestinal cancers. It was found that incidences of myosteatosis （low SMD） and myosteatosis （low SMI） are high, and the evaluation standards are gradually unified. However, the best cut-off value for myosteatosis （low SMD） and myosteatosis （low SMI） is still controversial. Furthermore, both myosteatosis （low SMD） and myosteatosis （low SMI） are associated with poorer treatment tolerance and clinical outcomes. In all, CT relevant parameters provide efficient tools in diagnosis and prognosis prediction for patients with gastrointestinal cancers, with important clinical application value.
2019 Vol. 6 (4): 494-498 [Abstract] ( 449 ) HTML PDF (636 KB)  ( 290 )
499 Interplay between chromatin modifications and metabolism in cancer
XIANG Ying, XIONG Jie, LI Feng
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.021
The expression levels of oncogenes and tumor suppressor genes are altered significantly by epigenetic changes in cancer cells. In addition, tumor cells are associated with metabolic reprogramming events such as increased glucose consumption, decreased oxidative phosphorylation, and large amounts of lactic acid production, providing more intermediate metabolites for biosynthesis and rebalancing the redox state of tumor cells. Both epigenetic and metabolic changes are distinct hallmarks of cancer. Along with the research,it now become evident that there is an important bidirectional regulatory mechanism between cancer metabolism and epigenetics （mainly refer to chromatin modifications）. Metabolic reprogramming may affect the availability of cofactors required for normal function of epigenetic enzymes, and the oncometabolites probably act as agonists and/or antagonists of these enzymes, therefore affecting the epigenetic landscape. Moreover, chromatin modifications are able to directly regulate the expression of metabolic enzymes or change the signal transduction cascade involved in cell metabolism. Thus, epigenetic-metabolomic interplay plays a crucial role in tumorigenesis by sustaining cell proliferation, metastasis and pluripotency. Here, we summarized the mechanisms underlying mutual regulation of chromatin modifications and metabolism in cancer by reviewing the recent research progress, to explain their potential role in tumorigenesis, and provided new strategies for the development of therapies targeting epigenetic modifications and metabolism in cancer.
2019 Vol. 6 (4): 499-504 [Abstract] ( 361 ) HTML PDF (760 KB)  ( 316 )
505 Indoleamine 2,3-dioxygenase and tumor immune tolerance
ZHANG Kang-ping, ZHANG Qi, YU Kai-ying, RAO Ben-qiang, SHI Han-ping
DOI: 10.16689/j.cnki.cn11－9349/r.2019.04.022
The immune system of human has been described to be able to produce the immune response to multiple abnormal antigens by tumors. Nevertheless, the immune tolerance of tumors, which induced by complex evolutionary steps of tumors, can reduce the hosts autoimmune response to tumors. Therefore, the phenomenon of immune tolerance may cause tumor to evade the hosts immune surveillance and attacks from the hosts immune effector cells. In turn, tumors have the opportunity to  proliferate and metabolize in the body. Indoleamine 2,3-dioxygenase （IDO） is a key enzyme entailed in immunosuppression that promotes the development of immune tolerance in a variety of pathophysiological processes. A large number of studies have found that IDO is an important inhibitory immune checkpoint, and the increase of its activity in patients will promote the establishment of immune tolerance. This article reviews the origin, expression and function of IDO as well as the mechanisms by which IDO promotes the establishment of tumor immune tolerance. Hence, the present review provides a broader perspective for IDOs further research and application in cancer therapy.
2019 Vol. 6 (4): 505-510 [Abstract] ( 300 ) HTML PDF (810 KB)  ( 228 )
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