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2020 Vol. 7, No. 2
Published: 2020-06-09
 
141 “6-word-tenet” for malignant bowel obstruction
Chen Yongbing， Yu Kaiying， Rao Benqiang， Shi Hanping
DOI: 10.16689/j.cnki.cn11－9349/r.2020.02.002
Malignant bowel obstruction （MBO） is one of the most common complications of advanced cancer， which seriously influences the quality of life and the survival time of cancer patients. The complexity of malignant tumors lead to the difficulty treatment options for bowel obstruction. Some studies on MBO treatment with conservative medical therapy show some appreciated effects， but there is no consensus. Most of the treatments were given as hospice care. Clinicians should fully consider the benefits and risks of treatment and carefully choose a personalized treatment program in clinical treatment. Based on the recent advances， current status， and our clinical experiences of treating MBO， we proposed a “6-words principal”. It composed of decompression， nourishment， octreotide， steroid， diuretic， peristalsis， which would improve the treatment effect of MBO and brings hope for MBO patients
2020 Vol. 7 (2): 141-144 [Abstract] ( 563 ) HTML PDF (850 KB)  ( 422 )
145 Progress on the mechanism and clinical application of gut microbiota in tumor immunotherapy
Zhang Xueying， Qin Huanlong
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.003
Guide::null
Tumor immunotherapy has become the new frontier of cancer therapy after surgery， chemotherapy and radiotherapy. Application of this therapeutics has generated extraordinary breakthroughs in some epithelial tumors and hematological tumors. However， there are currently two main problems in its clinical application， namely common adverse reactions and inadequate response rate in some solid tumors. With the advancement of genomics and metabolomics， people begin to appreciate the roles of gut microbiota in cancer development and treatment. The microbial community may affect the tumor immunity by modulating the host immune system and tumor microenvironment in which some microbes play antitumor roles by activating immunity while others mediate immune suppression to help cancer cells escape from the immune system. A growing body of studies have revealed that the efficacy and complications of immunotherapy are related to the gut microbiota in patients and that the hosts who are responsive to immunotherapy or prone to adverse reactions have certain microbiome traits. These microbial variables may be employed as biomarkers to predict the prognosis of immunotherapy or they may be developed as “immune-potentiators” （such as Akkermansia muciniphila and Bifidobacteria） to assist immunotherapy. A number of pre-clinical and clinical trials have demonstrated that microbial interventions including fecal microbiota transplantation can to a certain extent improve the sensitivity or reduce side effects of immunotherapy. With the development of gene editing and nanotechnology， it has been a new field of active interest to develop immunotherapy-friendly engineered bacteria. Taking advantage of the intricate relationship between intestinal flora and immunotherapy， we are hoping to mine microbial information and develop appropriate and actionable microbial interventions， thereby optimizing and making new headways in the immune-based therapeutics.
2020 Vol. 7 (2): 145-150 [Abstract] ( 468 ) HTML PDF (851 KB)  ( 459 )
151 Interpretation of Chinese experts consensus on nutritional therapy access of cancer patients:  surgical jejunostomy
Wu Zixiang， Wang Qi， Zhan Tianwei， Fang Shuai， Dong Lingjun， Wu Ming
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.004
Most patients with malignant tumors are malnourished， especially patients with digestive tract cancer. Because upper gastrointestinal cancer patients usually have long-term eating restrictions， complicated by the consumption of the tumor itself combined with surgical trauma and the need for fasting within a short period of time after surgery， the systemic nutritional status of patients further deteriorates； this deterioration of nutritional status leads to patients having increased perioperative complications， prolonged hospital stays， and even increased risk of death. Therefore， perioperative nutritional support for such patients is particularly important. Enteral nutrition is the preferred route of nutrition therapy and surgical jejunostomy is one of the main techniques to enable enteral nutrition. Jejunostomy allows patients with upper gastrointestinal cancer to receive early and long-term enteral nutrition after surgery， supplementing nutrition for patients with difficulty eating or postoperative fasting. This nutrition reduces the incidence of postoperative complications and shortens the length of hospital stays， even improving surgical and clinical outcomes. This article mainly describes the current progress， indications and complications of surgical jejunostomy.
2020 Vol. 7 (2): 151-154 [Abstract] ( 415 ) HTML PDF (386 KB)  ( 461 )
155 Medical nutritional therapy for patients with liver cancer
Zhu Mingwei， Liu Chengyu
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.005
 Liver cancer is a common malignant tumor in China.  The incidence of malnutrition is high in patients with liver cancer， the main reasons affecting their nutritional status at the time of the first hospitalization are the degree of liver damage and the tumor-burdened state. The anti-tumor treatment measures such as liver resection， radiotherapy， chemotherapy and targeted therapy can further aggravate the liver function injury and worsen the nutritional status. Medical nutrition intervention is an important part of the treatment of liver cancer. The standardized diagnosis and treatment procedures for the medical nutrition treatment of liver cancer patients include： “screening， assessment， and intervention”. Nutritional risk screening （e.g.， nutritional risk screening 2002） is used to identify patients requiring nutritional treatment. Malnutrition was diagnosed by means of patient-generated subjective nutrition assessment（PG-SGA） and liver function was assessed by laboratory examination and Child-Pugh classification grading. Energy and protein supply targets are determined according to the metabolic capacity and body demand of liver cancer patients. Oral nutritional supplement is the first choice for liver cancer patients with nutritional risk or malnutrition. For those who cannot meet 60% of the energy supply of enteral nutrition or cannot accept enteral nutrition， supplemental parenteral nutrition should be given timely to maintain nutritional status， improve he compliance of anti-tumor treatment and improve clinical prognosis. Abnormal liver function in patients with liver cancer can lead to the deficiency of various trace elements and vitamins， timely and appropriate supplementation of micronutrients has positive significance for improving nutritional status and maintaining liver function in patients with liver cancer.
2020 Vol. 7 (2): 155-159 [Abstract] ( 437 ) HTML PDF (459 KB)  ( 363 )
160 Guideline on cancer immunonutrition
Cui Jiuwei， Zhuo Wenlei， Huang Lan， Xu Chuan， Sun Xuejun， Liu Yudi， Tian Huimin， Liang Tingting， Chen Ping， Chen Bo， Liu Qiuyan， Ying Jie’er， Li Ningning， Zhang Anping， Yu Yang， Zhou Zhifeng， Wu Xiufe
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.006
Immunonutrition is a kind of targeted nutrition therapy that plays a significant role in the regulation of immune， metabolic and inflammatory changes during tumor development. It is an important branch of cancer nutrition therapy and has been widely used in many fields， such as surgery， radiotherapy and chemotherapy， and the treatment of cancer complications. However， although several international nutrition guidelines have addressed the use of immunonutrients in the clinical treatment of cancers， most of which are only scattered parts of the guidelines and lack of systematic collation and induction， and several relevant contents in the guidelines and clinical research results are still controversial. In addition， the deficient understanding of the specific mechanism and curative effect of tumor immune nutrients currently has further led to the limitation and non-standardization of immunonutrition in clinical practice. Therefore， in order to better guide clinical practice， through the collection and collation of critical clinical research results and authoritative guidelines published in recent years under the guidance of evidence-based medicine， experts of the Cancer Nutrition Committee of Chinese Anti Cancer Association have systematically analyzed and repeatedly proofread diverse research evidence， and put forward strict recommendations according to the evidence and recommendation levels in the rating criteria of Oxford Centre for Evidence-based Medicine， with a view to update the 2016 cancer immunonutrition guideline and provide a reference and basis for future standardized immunonutrition therapy for clinical cancer patients.
2020 Vol. 7 (2): 160-168 [Abstract] ( 848 ) HTML PDF (684 KB)  ( 902 )
169 Expert consensus on appetite assessment and regulation in cancer patients
Li Zengning， Li Xiaoling， Chen Wei， Qi Yumei， Hu Wen， Ge Sheng， Zhou Chunling， Yang Xuefeng， Zhang Pianhong， Lai Jianqiang， Jiao Guangyu， Hu Huaidong， Gao Shuqing， Wang Xiaolin， Zhang Yongsheng， Hu Xi
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.007
Loss of appetite is a common symptom in cancer patients， and the incidence of cancer anorexia cachexia syndrome is higher in advanced cancer patients. Due to insufficient nutrition intake， cancer patients will suffer from pancytopenia， weight loss， loss of fat tissue and skeletal muscle， resulting in decreased immunity， decreased treatment tolerance， reduced treatment opportunities， and increased complications. These problems are not conducive to the implementation of anti-cancer treatment measures. Accurate assessment of the process of cancer anorexia is of great importance for both research and clinical treatment. Scientific methods and techniques of appetite assessment are not only tools for nutritionists to evaluate appetite objectively， but also the basis for further understanding and prediction of malnutrition， which have positive significance for improving malnutrition in cancer patients. According to the existing research evidence， this consensus systematically summarized the research results in this field. Starting from the relationship between tumor， nutrition and appetite， this paper analyzed the mechanism of the occurrence and development of cancer anorexia. We summarized the evaluation methods of appetite in tumor patients under different conditions and gave expert recommendations. Combined with the status and characteristics of diet in China， this paper proposed the methods of improving appetite from the perspectives of clinical practice， nutrition， nursing and traditional Chinese medicine. We scientifically standardized the management strategy of cancer anorexia， so as to facilitate the application of clinicians， clinical nutrition professionals， nurses and other medical care personnel to better serve the cancer patients.
2020 Vol. 7 (2): 169-177 [Abstract] ( 890 ) HTML PDF (650 KB)  ( 763 )
178 The nutritional risk and the relation to length of hospital stay among patients with retroperitoneal tumor
Huang Jing， Liu Li， Liu Lihui， Zhang Lin， Zhang Jie， He Ying， Liu Xiaoyan
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.008
Objective  This study aimed to explore the relationship between nutrition risks and length of hospital stay in patients with retroperitoneal tumor， and to provide the strategy of clinical nutritional support therapy. Methods  60 patients with retroperitoneal tumor were recruited from a tertiary academic hospital in Chengdu. Nutritional risk was assessed by the European nutritional risk screening scale （NRS 2002） in a retrospective study．In addition， some data on admission and discharge were collected， such as body mass index （BMI）， blood albumin， blood hemoglobin， length of hospital stay （LOS）， postoperative nausea and vomiting （PONV）， exhaust time， defecation time， and time for dieting after surgery. One-way ANOVA were used to compare the length of hospital stay of patients between two groups and three groups， respectively. Multiple linear stepwise regression analysis was used to analyze the influence factors of length of hospital stay of patients. Results  Among all patients with retroperitoneal tumor （n=60）， the prevalence of nutritional risk before and after operation were 66.7% and 86.7%. Univariate analysis of the factors influencing the LOS of patients showed that patients with nutritional risks were more likely to stay longer in hospital compared to those without （P<0.001， P=0.043）. Others factors associated with prolonged LOS were low blood albumin level （P=0.019， P=0.025） during perioperative period， low blood hemoglobin level （P=0.019） after surgery， and PONV （P=0.001）. A positive correlation between exhaust time， defecation time， time for dieting after surgery and LOS was observed， and the strength of the association was strong （r=0.759-0.770； P<0.001）.Multiple linear stepwise regression analysis indicated that the NRS 2002 of patients with retroperitoneal tumor was significantly predict LOS among the participants （β=0.399）.  Conclusion  Nutritional  risk assessed by NRS 2002 on admission predicts LOS for patients with retroperitoneal tumor. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces LOS.
2020 Vol. 7 (2): 178-182 [Abstract] ( 490 ) HTML PDF (415 KB)  ( 230 )
183 Analysis of nutritional status and postoperative infection in patients with gastrointestinal cancer
Liu Zuping， Bai Lian，Zeng Yonghong，Tang Ying，Lyu Yunli，Chen Xiaoyu
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.009
Objective  To explore the nutritional status of patients with gastrointestinal cancer and analyze the impact of the nutritional status of patients on postoperative infections， and to provide evidence for prevention and control of postoperative infection. Methods  The relevant data of 271 patients with gastrointestinal cancer who underwent tumor surgery  Yongchuan Hospital Affiliated to Chongqing Medical University    from January 2016 to March 2019 were collected， the nutritional risk screening tool （NRS 2002） was used to screen the nutritional risk of patients before operation， according to the screening results， they were divided into nutrition risk group （121 cases） and non-nutrition risk group（150 cases），the differences between the two groups in general observation indexes， postoperative infection and admission to ICU were compared， and the correlation between the occurrence of postoperative infection and preoperative nutritional status， age， preoperative hematology indexes， surgical status， tumor status and other factors was analyzed. Results  The preoperative nutritional risk of patients with gastrointestinal cancer was 44.6%，the total protein， albumin， hemoglobin and lymphocyte in the nutrition risk group were lower than those in the non-nutrition risk group， and the difference were statistically significant （P<0.05）；the incidence of postoperative infection was 27.3% （33/121） in the nutrition risk group and 14.7% （22/150） in the non-nutrition risk group， the difference between the two groups was statistically significant. Multivariate Logistic regression analysis showed that the risk factors of postoperative infection were associated with NRS 2002 ≥ 3 points， drinking history， and operation duration ≥6h， and the differences were statistically significant （P<0.05）.  Conclusion  The incidence of preoperative nutritional risk in patients with gastrointestinal cancer is high， the incidence of postoperative infection is high in patients with low NRS 2002 score， active measures should be taken to improve the nutritional status of patients.
2020 Vol. 7 (2): 183-187 [Abstract] ( 347 ) HTML PDF (424 KB)  ( 281 )
188 Skeletal muscle measurement and PG-SGA in nutritional assessment of patients with gastric cancer
Peng Haiyan， Dai Jing， Wang Wenbo， Peng Jin， Xia Ling， Li Yi，Xie Conghua，Xu Hongxia，Shi Hanping，Zhou Fuxiang
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.010
Objective  To investigate the correlation between skeletal muscle index （SMI）， skeletal muscle density （SMD） and PG-SGA scores in nutrition assessment among gastric cancer patients. Methods  A total of 118gastric cancer patients from Zhongnan Hospital of Wuhan University from January 2017 to November 2019 were screened and included from National Cancer Patient Nutrition Survey Platform. The nutrition scores and other basic information were collected， and then we passed through the PACS system in the imaging department of our hospital to find the images in the 3rd lumbar spine plane that we needed. After finished calculating the SMI and SMD， Pearson correlation analysis was used to analyze the correlation between the PG-SGA score and SMI， SMD. Results  Among these 118 patients with gastric cancer， the mean level of SMI was about （34.34±8.01）cm2/m2， 95% confidence interval （95%CI ） was from 32.78 to 35.84， and the average of SMD was （42.44±7.34）HU， 95%CI was from 41. 06 to 43.97. Men were both higher than women in the two characteristics （P<0.05）. PG-SGA scores ranged from 1 to 20， with an average of （6.73±4.30），and 95%CI was from 5.91 to 7.56. There was a significant correlation between SMI and PG-SGA scores （r=-0.608，P<0.01）， but there was no significant correlation between SMD and PG-SGA scores （r=-0.045，P=0.651）.  Conclusion  In gastric cancer， the SMI and PG-SGA are consistent in assessing the nutritional status of patients.
2020 Vol. 7 (2): 188-192 [Abstract] ( 423 ) HTML PDF (460 KB)  ( 275 )
193 Correlation analysis of FA， VitB12， Fer， HCY and prognosis in patients with malignant tumor of digestive system
Zhou Kun， Zheng Zunrong， Zhou Yuzhen
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.011
Objective   To investigate the effect of folic acid（FA）， vitamin B12 （VitB12）， ferritin（Fer） and homocysteine（HCY） on the prognosis and survival of gastric cancer， colon cancer and liver cancer patient. Methods  From February 2013 to August 2018，a total of 317 patients diagnosed with malignant tumor complicated with anemia were selected from General Hospital of Heilongjiang Province Land Reclamation Bureau， including 113 cases of gastric cancer， 120 cases of colon cancer and 84 cases of liver cancer. Anemia indicators and HCY were detected in 317 patients respectively. Cox regression model was used to analyze the prognostic factors of patients， and Kaplan-Meier method was used to draw the survival curve. Results  Multivariate Cox regression analysis showed that VitB12 was an independent prognostic factor in patients with gastric cancer anemia （P=0.008）； The expression level of FA， Fer and HCY can be used as prognostic factors for patients with colon cancer anemia （P=0.01， P=0.001， P=0.002）；Fer and HCY can be used as prognostic factors for patients with liver cancer （P=0.006， P=0.014）. Kaplan-Meier survival curve analysis showed that the level of VitB12  had no significant effect on the survival rate of patients with anemia of stage Ⅰ and Ⅱ gastric cancer （P=0.174）；Patients at stage Ⅲ and Ⅳ， the survival rate of patients lacking VitB12 was significantly lower than that of patients with normal VitB12（P=0.043）. Regardless of stage， the survival rate of colon cancer patients lack FA and HCY increased was poor. In the liver cancer group， survival rates were significantly reduced in patients with Fer and HCY increased，regardless of stage.  Conclusion  The levels of FA， VitB12， Fer and HCY are significantly correlated with the prognosis of patients with anemia of digestive tract malignant tumors. They can be used as nutritional monitoring indicators for patients with anemia of digestive tract malignant tumors， assisting in determine the anemia degree and type of patients， improving tumor treatment strategy and the prognosis.
2020 Vol. 7 (2): 193-198 [Abstract] ( 356 ) HTML PDF (2353 KB)  ( 231 )
199 Effect of probiotics combined with enteral nutrition on intestinal flora and peripheral blood miR-155 in patients with acute pancreatitis
Wang Yan， Shi Jian， Gong Liya， Wang Fengjiao
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.012
Objective   To investigate the effect of probiotics combined with enteral nutrition on intestinal flora and peripheral blood miR-155 in patients with acute pancreatitis. Methods  92 patients with acute pancreatitis admitted to the Department of digestive medicine of our hospital from June 2016 to December 2018 were selected as the study subjects， according to the random number table method， the patients were divided into observation group （n=46） and control group （n=46）， the control group was given enteral nutrition treatment on the basis of routine treatment， while the observation group was given Live Combined Bifidobacterium and Lactobacillus Tablets on the basis of the control group， the changes of intestinal flora， inflammatory mediators and serum miR-155 were observed before and after treatment， and the recovery of gastrointestinal function was compared between the two groups. Results  After treatment， the number of bifidobacteria and lactobacillus increased and the number of enterococcus and escherichia coli decreased in observation group， and the reduced serum levels of CRP， IL-6， IL-17， TNF-α， and mi5-155 were significantly higher than those of control group （P<0.05）.The gastrointestinal quality of life scale （GIQLI） score of patients in observation group was higher than that of control group， and the time for the disappearance of abdominal distension， the time for the disappearance of abdominal pain， the time for the recovery of bowel sounds， and the time for the recovery of serum amylase were all less than that of control group （P<0.05）. Conclusion  Probiotics combined with enteral nutrition in the treatment of acute pancreatitis can regulate the balance of intestinal flora， reduce the level of serum miR-155， alleviate inflammation and promote the recovery of intestinal function.
2020 Vol. 7 (2): 199-203 [Abstract] ( 347 ) HTML PDF (571 KB)  ( 262 )
204 Effect of depression on nutritional status of patients with nasopharyngeal carcinoma receiving radiotherapy
Zheng Xianbin，Gao Jin，Hua Lei，Guo Weiqian2， Tao Zhenchao，Zhang Yangyang
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.013
Objective   To evaluate the effect of depressive symptoms on the nutritional status of patients with nasopharyngeal carcinoma receiving radiotherapy. Methods  According to the evaluation results of the HAD scale before radiotherapy， 77 patients with nasopharyngeal carcinoma who met the inclusion criteria were divided into the depressive group and the non-depressive group. Observe and evaluate the nutritional status changes of depression group （n=32） and non-depression group （n=45） before radiotherapy and the end of radiotherapy， and analyze the effect of depression on the nutritional status of patients. Results  In this study， we found that about 41.6% of patients had depressive symptoms before radiotherapy. The average serum albumin and hemoglobin levels in the depression group at the end of radiotherapy were significantly lower than those in the non-depression group［ （38.5±5.8） mg/dl  vs  （41.0±5.2） mg/dl，P=0.045；（108.3±31.6）g/L  vs  （111.6±16.6）g/L，P=0.041］， patients in depression group were more prone to weight loss ≥5%， BMI<18.5kg/m2 and NRS 2002 score ≥3 （75.0%  vs 33.3%）， P=0.001； 28.1%  vs  8.9%， P=0.026； 46.9%  vs  17.8%， P=0.006）. Conclusion  The depressive symptoms of patients with nasopharyngeal carcinoma are closely related to their nutritional status. In patients with nasopharyngeal carcinoma receiving radiotherapy， depressive symptoms may be used as predictors of malnutrition.
2020 Vol. 7 (2): 204-208 [Abstract] ( 290 ) HTML PDF (437 KB)  ( 243 )
209 Prognostic significance of prognostic nutritional index in advanced colorectal cancer with third-line therapy
Li Yiming， Zou Man， Zhuang Liang， Zou Yanmei， Zhang Mingsheng， Qiu Hong， Dai Yuhong
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.014
Objective  To investigate the prognostic value of prognostic nutritional index （PNI） in the advanced colorectal cancer patients of third-line therapy. Methods  Clinical data of 43 advanced colorectal cancer patients were retrospectively analysed， who were treated with S-1 plus apatinib as third-line therapy. PNI（prognostic nutritional index）， AGR（albumin-to-globulin ratio）， PLR （platelet lymphocyte ratio）and LMR（lymphocyte monocyte ratio） were calculated. Cox proportional hazards regression models and Kaplan-Meier curve were used to evaluate the impact on survival. Results  According to receiver operating characteristic （ROC） curves， the cutoff value for PNI was 47.08； the result of univariate analysis showed PNI， AGR， ECOG， HGB， NLR and LMR were significantly correlated with overall survival （OS）； multivariate analysis showed that ECOG and PNI were independent prognostic factor of OS. The median overall survival for PNI-low patients were 5.70months（95%CI=4.42-6.98）， while the mOS for PNI-high patients were 15.77months（95%CI=7.43-24.1），P=0.000.The mPFS for PNI-low and PNI-high patients were 3.42months（95%CI=2.31-4.53）and 6.29months（95%CI=4.96-7.62）respectively，P=0.003.  Conclusion  PNI could be a useful prognostic indicator for advanced colorectal cancer patients who received the combination of S1 plus apatinib as third-line treatment.
2020 Vol. 7 (2): 209-213 [Abstract] ( 357 ) HTML PDF (1025 KB)  ( 286 )
214 Investigation on nutritional risk of patients with lung cancer surgery and its effect on clinical outcomes
Chen Wei， Ding Qin，Chen Jian， Jiang Lei
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.015
Objective  The aim of this paper was to evaluate the nutritional status of patients undergoing lung cancer surgery in Shanghai Pulmonary Hospital， Tongji University and analyze the related factors of nutritional risk and assess the impact of nutritional risk on clinical outcomes， to provide a scientific reference for nutrition interventions of patients with lung cancer surgery. Methods  Collect data of patients undergoing lung cancer surgery in Shanghai Pulmonary Hospital， Tongji University from January 2014 to December 2017. The nutritional risk and malnutrition rate of lung cancer surgery patients was assessed by the nutritional risk screening 2002 （NRS 2002） and general information and nutrition relevant indicators results of the patients were recorded. Results  Data of 640 patients with lung cancer surgery who met the inclusion and exclusion criteria were collected in this study. The incidence of nutritional risk was 41.6%， of which the incidence was higher in women than in men （χ2=6.80， P<0.05）； The incidence of patients whose age over 65 years was higher than those of patients under 65 years （χ2=35.96， P<0.001）； The incidence of nutritional risk was statistically different among lung cancer patients with different surgical methods （χ2=17.96， P<0.001）；There were significant differences in the incidence of nutritional risk among patients with different grades of surgery （χ2=6.61， P<0.05） and the incidence increased with the grade of surgery. In addition， the incidence of nutritional risk in patients with lung cancer surgery was significantly different between the body mass index（BMI） below the normal range， the BMI in normal range （18.5-23.9kg/m2）， and the BMI above the normal range （χ2=168.80，P<0.001） and the incidence of nutritional risk decreases as the BMI value increase. There was no significant difference in the incidence of nutritional risk among patients with different pathological types of lung cancer （χ2=0.19，P>0.05）. At the same time， we also found that patients with nutritional risk had a higher postoperative drainage volume （t=2.42， P<0.05）， a longer hospital length of stay （t=2.48， P<0.05）， and a higher hospitalization costs （t=2.45， P<0.05） than patients with normal nutrition and the differences were all statistically significant.  Conclusion   Nutritional risk is common in patients with lung cancer surgery and is associated with gender， age， surgical method and grade， and BMI. And the occurrence of nutritional risk can increase postoperative drainage volume， prolong hospital stay， and increase hospitalization costs. Therefore， nutritional risk screening and timely intervention for lung cancer surgery patients can improve their clinical outcomes.
2020 Vol. 7 (2): 214-219 [Abstract] ( 319 ) HTML PDF (455 KB)  ( 307 )
220 Prospective study on nutritional risk， undernutrition and nutritional support in patients with non-Hodgkin lymphoma
Mu Jiaye， Yu Qian， Guo Yiming， Qu Wei， Zhu Kun
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.016
Objective  To investigate the nutritional risk， malnutrition and nutritional treatment of non-Hodgkin lymphoma patients in the Third Hospital of Jilin University. Methods  Patients with non-hodgkin’s lymphoma in the Third Hospital of Jilin University from October 2017 to October 2019 were selected as the study subjects. Nutritional risk screening 2002 （NRS 2002） was used for nutritional risk screening within 48hours after admission to investigate the incidence of malnutrition and record the nutritional treatment during hospitalization. Results  The incidence of nutritional risk was 52.24% （n=70） in 134 patients. There were two sources of malnutrition： the incidence rate of malnutrition was 13.43% （n=18）， and the BMI<18.5kg/m2， respectively， was 13.45% （n=14）. There was no significant difference between male and female patients in the incidence of nutritional risk and malnutrition （P>0.05）. The incidence of nutritional risk and malnutrition in patients ≥60 years old was higher than that in patients<60 years old （P<0.05）. The proportion of nutritional risk patients receiving nutritional therapy was 54.29%.  Conclusion  The incidence of nutritional risk and malnutrition is high in patients with non-hodgkin’s lymphoma. NRS 2002 can screen out these patients and provide a basis for clinical rational nutritional treatment.
2020 Vol. 7 (2): 220-224 [Abstract] ( 305 ) HTML PDF (1463 KB)  ( 245 )
225 Study on the mechanism of miR-4298 targeting TGIF2 influencing the proliferation and migration of multiple myeloma cells
Du Jingzhu， Chen Qi， Yin Hao， Li Feng
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.017
Objective  To investigate the effect of microRNA-4298 （miR-4298） on proliferation， migration and invasion of multiple myeloma cells and its possible mechanism. Methods  Fluorescence quantitative PCR （qPCR） was used to detect the expression level of miR-4298 in multiple myeloma cell lines （U-266， SKO-007， RPMI-8226）； RPMI-8226 cells were randomly divided into the control group （conventional cultured cells），  the miR -NC group （negative control of miR-4298 transfection）， and the miR-4298 group （miR-4298 mimic transfection）； qPCR detection of transfection effect， using cell count （CCK-8）， cell scratch and Transwell test respectively RPMI-8226 cell proliferation， migration and invasion ability， TargetScan prediction， dual luciferase reporter gene verification miR-4298 and transforming growth interaction factor 2 （IGFIF2） targeting relationship； Western blot detection of TGIF2 protein levels.Results  The expression of miR-4298 in multiple myeloma cell lines （U-266， SKO-007， RPMI-8226） were down-regulated （P<0.05）. Up-regulation of miR-4298 inhibited the proliferation of RPMI-8226 cells （P<0.05）， and decreased the migration and invasion of RPMI-8226 cells （P<0.05）. TGIF2 was the downstream target gene of miR-4298. miR-4298 was negatively correlated with TGIF2 protein level. Up-regulation of TGIF2 could reverse the inhibitory effect of miR-4298 on proliferation， migration and invasion of RPMI-8226 cells. Conclusion  miR-4298 is down-regulated in multiple myeloma cell lines， which may inhibit the proliferation， migration and invasion of RPMI-8226 cells by inhibiting TGIF2.
2020 Vol. 7 (2): 225-230 [Abstract] ( 300 ) HTML PDF (2408 KB)  ( 219 )
231 Study on the intervention of individualized nutrition therapy in patients with postoperative chemotherapy of gastric cancer and the analysis of factors affecting their quality of life
Zhang Wenrong， Han Ying， Deng Hailian， Zhang Lijuan
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.018
Objective  To investigate the influencing factors of quality of life and individualized nutritional intervention in patients with gastric cancer after chemotherapy. Methods  From January 2017 to January 2019， 100 patients admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University were divided into the observation group （n=50） and the control group （n=50） given different nutritional intervention. The patients in the observation group were treated with individualized nutrition intervention， while the control group was treated with routine nutrition intervention. The changes of body mass index， nutrition index and peripheral blood index， the probability of complications and the score of quality of life in the two groups were compared before and after chemotherapy， and the factors affecting the quality of life of patients with gastric cancer after chemotherapy were analyzed by multivariate Logistic regression analysis. Results  The body mass index （BMI）， nutrition index （PNI）， prealbumin （PALB）， serum albumin （ALB） and transferrin （TRF） were significantly higher in the observation group than those in the control group. After nutritional intervention， BMI and TRF in the two groups showed an upward trend compared with those before chemotherapy， and the difference was statistically significant（P<0.05）. The probability of complications was significantly lower in the observation group than in the control group.（ χ2=4.336，P=0.037）. After chemotherapy， the scores of overall health status in the two groups were significantly higher than those in the control group， while the scores in the three symptom areas in the observation group were significantly higher than those in the control group（P<0.05）. Logistic regression analysis found that lymph node metastasis， monthly household income ≤5000 yuan， combined organ resection， rural residence and malnutrition were the main factors affecting the quality of life of gastric cancer patients after chemotherapy.  Conclusion  Lymph node metastasis， working condition， combined organ resection， surgical scope and nutritional status have important effects on the quality of life of patients with gastric cancer after chemotherapy. Individualized nutrition intervention can promote the improvement of physical indexes of patients with gastric cancer after chemotherapy， which is beneficial to improve the quality of life of patients with gastric cancer.
2020 Vol. 7 (2): 231-235 [Abstract] ( 384 ) HTML PDF (431 KB)  ( 233 )
236 Review on metabolism and nutrition after androgen deprivation therapy in prostate cancer patients
Cai Jianliang1， Dong Guang2， Shi Hanping3
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.019
Prostate cancer is among one of the most common malignant tumors in men， and androgen deprivation therapy is the first-line treatment for prostate cancer. Prolonged androgen deprivation therapy for patients with prostate cancer who continues to be in a state of low androgen will have a series of metabolic and nutritional problems， including increased risk of obesity， diabetes， abnormal fat metabolism， metabolic syndrome， and cardiovascular disease， etc. The adverse health effect has a negative influence on patient’s quality of life， the implementation of cancer sequential treatments， and the prognosis. However， there are few relevant researches in this field. This article focuses on the metabolism and nutritional issues of prolonged androgen deprivation therapy for prostate cancer patients， discusses in-depth on the obesity， diabetes， dyslipidemia， and metabolic syndrome， and prospects for future research.
2020 Vol. 7 (2): 236-239 [Abstract] ( 343 ) HTML PDF (998 KB)  ( 222 )
240 Relationships between malnutrition and tumor metastasis and potential mechanisms
Liu Qian1，Yin Zhenyu1，Qu Caihao，Li Xuemei，Li Xiaomei，Qi Wenbo， Liu Le，Bai Yuping， Chen Hao
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.020
The incidence of malnutrition in cancer patients is very high. Malnutrition will reduce the clinical efficacy，survival rate， and affect the quality of life of patients. Malnutrition and tumor metastasis interact and promote each other， which are the higher the incidence of malnutrition， the higher the rate of tumor infiltration and metastasis， the more severe the degree of malnutrition infiltration and metastasis. At the same time， with the metastasis of tumors， the incidence of malnutrition in patients also increases， ultimately， increasing the mortality rate of patients. The underlying cause of malnutrition in cancer patients is reduced nutrient intake and increased consumption. Various complications caused by the tumor itself， metabolic disorders caused by the tumor， various inflammatory factors secreted by the tumor cells， various adverse reactions and surgical complications during the treatment， and psychological factors of anxiety and depression of patients are all related to malnutrition. Malnutrition promotes tumor metastasis， and its specific mechanism may be related to the impaired immune function， inflammatory response， decreased leptin level， angiopoietin-like protein， autophagy of tumor cells， and so on. The treatment of malnutrition in patients can reduce the risk of tumor metastasis and prevent tumor metastasis can improve the nutritional status of patients. The study of the mechanisms related to malnutrition and infiltration and metastasis in cancer patients can provide a new direction for tumor treatment.
2020 Vol. 7 (2): 240-244 [Abstract] ( 408 ) HTML PDF (995 KB)  ( 290 )
245 Research progress of the nutritional status and nutrition therapy for colorectal cancer patients undergoing chemotherapy
He Yanling， Cai Hua， Zhang Junling， Yang Yuming， Peng Ya
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.021
Colorectal cancer is a common gastrointestinal tumor with a high incidence of severe malnutrition. Chemotherapy is one of the common treatment methods for colorectal cancer and is independently related to malnutrition. After chemotherapy， the risk of malnutrition is further exacerbated. At the same time， malnutrition can lead to poor chemotherapy efficacy and poor prognosis of patients， and increase chemotherapy-related adverse reactions， affect patients’ the quality of life and reduce survival rate. Nutritional support therapy plays an important role in comprehensive tumor treatment， which can effectively improve the nutritional status of patients， and multiple disciplinary team is an effective nutritional intervention model. The current nutritional support therapy mainly includes nutrition consultation， oral nutritional supplements， enteral nutrition and parenteral nutrition. Relevant guidelines and research indicate that oral nutritional supplements and enteral nutrition should be preferred in nutritional support therapy， and parenteral nutrition is only performed when the nutritional deficiency after the above treatment or enteral nutrition is not available. This paper reviews the relationship between nutritional status and chemotherapy in colorectal cancer patients， and the latest research progress and related guidelines of nutritional support therapy， in order to attract clinical attention to nutritional support therapy in colorectal cancer patients undergoing chemotherapy and provide reference.
2020 Vol. 7 (2): 245-249 [Abstract] ( 445 ) HTML PDF (429 KB)  ( 473 )
250 Research progress on diagnosis and treatment of sarcopenia in tumor patients
Zou Hongbo， Yan Xialin，Yu Dingye， Yu Zhen
DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.022
Abnormal metabolism in tumor patients， known as the metabolic reprogramming of tumor is one of the key characteristics of tumorigenesis. The rapid-growth tumor is compelled to compete for more nutrient. The need for high energy and low-energy aerobic glycolysis allow the body’s functional proteins to be used as energy， making it difficult to meet the normal physiological needs of patients. The complex nutritional metabolism of tumors and excessive protein consumption can reduce muscle mass and impair muscle function in cancer patients. The initial research of our team found that postoperative fatigue syndrome generally occurs in patients with abdominal tumors， and skeletal muscle function was significantly decreased after undergoing perioperative fasting and gastrointestinal surgery remodeling. Further clinical studies indicated that sarcopenia is an independent predictor of prognosis in patients with gastrointestinal tumors regardless of nutritional risk. Therefore， sarcopenia is an important concern for tumor patients during the perioperative period. It is of great clinical significance to include the diagnostic standard of sarcopenia in routine screening for tumor patients before surgery. It would enhance recovery after surgery and improve clinical outcomes if proper clinical interventions were carried out   for the tumor patients with sarcopenia， and it  would improve the life quality of tumor patients and reduce healthcare costs.
2020 Vol. 7 (2): 250-254 [Abstract] ( 501 ) HTML PDF (442 KB)  ( 562 )
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