Electron J Metab Nutr Cancer

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2020 Vol. 7, No. 3 Published: 2020-09-09

	255	Muscle protein breakdown in cancer cachexia#br#
		Zhang Ying, Wang Xinying
		DOI: 10.16689/j.cnki.cn11－9349/r.2020.03.001
		Muscle wasting is the central characteristic of cancer cachexia, which is associated with increased postoperative complication rates, increased susceptibility to chemotherapy toxicity, and decreased chance of survival. The muscle loss is caused by an imbalance between protein synthesis and degradation. In cancer patients, increased muscle protein breakdown seemed to play a more important role than decreased protein synthesis. The ubiquitin proteasome system (UPS) and autophagy lysosome system (ALS) are major intracellular proteolytic systems. UPS is the primary proteolytic route for short-lived, misfolded, and damaged proteins. It has important functions in the regulation of cell signaling and transcription and is involved in a variety of cellular functions, including cell cycle progression, cell survival, proliferation, apoptosis, and other critical cellular pathways. ALP recognizes and removes large and potentially dangerous cellular components such as protein aggregates and dysfunctional or superfluous organelles and has emerged as a crucial adaptive mechanism to cope with various cellular stresses. In the past, ubiquitin and the autophagy system were considered to be two independent systems. However, more and more studies show that they are closely related and functionally related systems,which serve complimentary roles in degrading cellular constituents and might be coordinately activated by common signaling mechanisms. In this review we will describe the involvement of the ubiquitin proteasome and autophagy lysosome systems in cancer cachexia that regulate tumor-induced protein breakdown in muscle.
		2020 Vol. 7 (3): 255-258 [Abstract] ( 374 ) HTML PDF (442 KB) ( 411 )

	259	Medical diagnosis and treatment of malignant bowel obstruction
		Ma Huaixing, Li Suyi
		DOI: 10.16689/j.cnki.cn11－9349/r.2020.03.002
		Malignant bowel obstruction is one of the common complications of advanced tumors. The treatment is mainly based on comprehensive medical methods. Understanding the pathophysiological mechanism (including “uncoordinated peristalsis-tissue edema-uncoordinated peristalsis” and “secretion-expansion-secretion” vicious circle), clarify the classification and subtype of obstruction and completing the systematic evaluation of oncology (including general conditions, organ function, oncology evaluation, nutritional metabolism and intestinal barrier function), are the prerequisites for its effective treatment. The principle and purpose of treatment are to minimize or even relieve the bodys tumor load, to improve or cure the adverse symptoms, signs and intestinal dysfunction caused by intestinal obstruction, to correct the state of water and electrolyte disorders and nutritional metabolism disorders, and ultimately to improve the patients quality of life and overall survival. Specific measures includes basic treatment, nutritional therapy and metabolic regulation, anti-inflammatory, reducing intestinal wall edema, inhibiting the secretion of glands in the digestive tract, repairing the intestinal barrier and preventing infection, anti-tumor etiology treatment and exercise therapy, psychological support. Anti-tumor etiological treatment is a clinical difficulty, because malignant bowel obstruction is often accompanied by malnutrition and poor general conditions, and it is difficult to tolerate conventional anti-tumor therapy. Anti-tumor therapy needs to take into account tumor factors, nutritional status and patients general conditions. Effective anti-tumor treatment is the basic guarantee for intestinal obstruction recanalization.
		2020 Vol. 7 (3): 259-262 [Abstract] ( 400 ) HTML PDF (502 KB) ( 262 )

	263	Progress in home enteral nutrition on advanced cancer patients
		Bai Qian, Wang Jian
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.003
		Malnutrition is the most common complication and death factor in cancer patients, especially in advanced cancer patients. Due to the shortened length of hospital stay, changes in treatment methods and objectives, home nutrition support is widely accepted by patients. Reasonable and effective home nutrition therapy has a positive effect on improving the prognosis and quality of life of patients with advanced cancer. Meanwhile, home enteral nutrition has become the preferred method of home nutrition therapy for patients with advanced cancer due to its simplicity and safety. Standardized home enteral nutrition can effectively reduce the incidence of malnutrition, not only help to improve and to maintain the nutritional status of patients, to improve the quality of life, but also can meet their physiological and psychological needs, avoid long-term hospitalization. There are obvious social benefits in saving medical costs. However, the application of home enteral nutrition is undergoing challenges including enteral feeding devices, enteral nutrition formula components, practice innovation, and medical care. At present, it is urgent to explore a standardized, safe and reliable management implementation to achieve home enteral nutrition support and provide ideas for the establishment of a standardized home enteral nutrition model for patients with advanced cancer.
		2020 Vol. 7 (3): 263-266 [Abstract] ( 293 ) HTML PDF (591 KB) ( 264 )

	267	Metabolic disorder in MBO
		Luo Guijuan, Miao Mingyong
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.004
		Malignant bowel obstruction is malignant tumor associated intestinal obstruction common in patients with advanced ovarian cancer or gastrointestinal cancer. It’s one of the most lethal complications caused by tumor compression, tumor cell infiltration of autonomic nerves, paraneoplastic syndrome, or drug related factors. In this review, we delineate the current studies on metabolic disorders and mechanisms of malignant bowel obstruction at home and abroad and draw the following conclusions. Malignant bowel obstruction not only causes metabolic disorders of macronutrients such as glucose, protein, and fatty acids, but also causes micronutrients disorders. Intestinal dysfunction, inflammation and intestinal flora disorders, and lack of effective nutrition support contribute to the occurrence of malignant bowel obstruction. Metabolic disorders could aggravate obstruction and closely related to the prognosis. Clinical decision-making should pay attention to the metabolic situation. Recognizing the significant influence on the prognosis of patients, doctors should take active treatment to the metabolic disorder and improve quality of life.
		2020 Vol. 7 (3): 267-271 [Abstract] ( 336 ) HTML PDF (744 KB) ( 257 )

	272	Selection of nutrition route in malignant bowel obstruction
		Zhang Yongsheng, Liu Xidi, Chen Junqiang
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.005
		Malignant bowel obstruction (MBO) is one of the complications in tumor and have high rates in advanced tumors, which affected nutrients intake and leads to the occurrence or exacerbation of malnutrition. This may lower the quality of life and shorten the time of survival. Tumors metabolize vigorously during growth and it is highly susceptible to malnutrition, which may be significant increase and end with cachexia when the patient develop to intestinalobstruction. Malnutrition has become one of the leading causes of death in MBO patient. Nutritional therapy in MBO patients is the key in the treatment of MBO, timely and effective nutritional therapy can maintain the nutritional status and improve malnutrition, improve tolerance and effectiveness of various treatments. The selection of appropriate nutrition route is the basic guarantee for successful implementation of nutritional therapy, especially for patients with malnutrition and at nutritional risk. There is still controversy in nutrition route for MBO patients. We should choose individual nutrition route on the basis of the obstructive site, treatment, complication risks and estimated survival, et al. We summarizes the various common nutrition route in MBO patients, aiming to provide safe and effective nutrition route clinically.
		2020 Vol. 7 (3): 272-275 [Abstract] ( 324 ) HTML PDF (918 KB) ( 234 )

	276	Characteristics of malnutrition in malignant cancer patients
		Chinese Society of Nutritional Oncology
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.006
		There are significant differences between malnutrition caused by malignant tumors and benign diseases, which are manifested in the following seven aspects. ① the incidence of malnutrition is higher, 79.4% of inpatients with tumor have different degrees of malnutrition；② resting energy expenditure is increased: the energy expenditure of different tumors and different stages of the same tumor is different, but on the whole, the resting energy expenditure of patients with tumor increased by 10% on average, and the special glucose metabolism made the patients consume additionally about 300kcal energy every day；③ sustained physiological and psychological stress: the diagnosis of cancer itself, accompanying symptoms and treatment all brought huge trauma and stress to the patients body and mind；④ chronic low-grade irreversible inflammation: the nature of cancer is chronic low degree irreversible inflammation；its malnutrition is a kind of disorder accompanied by inflammatory reaction, that is, cachexia；⑤ wasting metabolic disorder: as a metabolic disease, malignant tumor is different from that of normal cells in the metabolism and metabolic reprogramming. Under the effect of inflammatory mediators and metabolic factors, there is significant wasting metabolic disorder；⑥ significant muscle loss: due to inflammatory reaction and catabolism, the whole body muscle loss of patients with malignant tumors are important reasons for weight loss；⑦ treatment is more difficult: it often requires more comprehensive treatment, especially metabolic modulation treatment. The more malignant the tumor is, the more obvious the above characteristics are. Malnutrition of malignant tumor has significant characteristics, so its treatment is also significantly different from that of benign diseases.
		2020 Vol. 7 (3): 276-282 [Abstract] ( 410 ) HTML PDF (1414 KB) ( 660 )

	283	Expert consensus on hyperhomocysteinemia#br#
		Bone Health and Nutrition Branch of Chinese Nutrition Society, Chinese Society of Parenteral and Enteral Nutrition, North Chronic Disease Prevention and Treatment Branch of Chinese Geriatric Society
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.007
		High homocysteine levels, and a variety of disease development, such as cardiovascular disease, hypertension, diabetes, and closely related diseases such as kidney disease, pregnancy, almost affect the whole body organs, through oxidative damage, DNA methylation and metabolic abnormalities and other mechanism of sulfur compound affect cell function, protein synthesis and regulation, leading to the pathological changes of tissues and organs. Currently, there is no guideline for the diagnosis and treatment of demographic characteristics in China. This expert consensus is based on the review and analysis of research literature and evidence-based medicine at home and abroad in the past 30 years, combined with the characteristics of the Chinese population, recommending that tHcy ≥ 10μmol/L is defined as hyperhomocysteinemia. By adjusting the diet composition and / or using dietary supplements such as betaine, vitamins B and related coenzyme nutritional supplements, the level of tHcy can be prominently reduced, which is expected to significantly slow down the development of related diseases. It is recommended to carry out the detection indicators related to homocysteine, so as to clarify the causes of homocysteine rise, to guide the clinical precise intervention measures, effectively to improve the level of homocysteine, and to achieve the purpose of preventing the occurrence of diseases or delaying the progress of diseases.
		2020 Vol. 7 (3): 283-288 [Abstract] ( 1158 ) HTML PDF (1035 KB) ( 766 )

	289	The analysis of venous thromboembolism risk and thromboprophylaxis in hospitalized cancer patients
		Qin Dan, Jin Shuai, Zhang Lichuan, Han Shuying, Shi Hanping, Lu Qian
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.008
		To evaluate venous thromboembolism risk in hospitalized cancer patients using the Khorana score, and compare thromboprophylaxis strategies of cancer patients at different risk levels of venous thromboembolism. Methods Cancer patients hospitalized in a tertiary hospital in Beijing during January 2017 and October 2019 were enrolled. Electronic medical records were reviewed to obtain patient characteristics, Khorana score, and thromboprophylaxis information. Results The median Khorana score of 1834 patients was 2(1, 2). 9.0%(165/1834),70.0%(1284/1834), and 21.0%(385/1834) of these patients were classified as low, intermediate and high-risk, respectively. 8.8% (83/941), 71.7% (675/941), and 19.4% (183/941) of surgical patients were in low, intermediate, and high-risk groups, respectively. While in patients only receiving chemotherapy, 6.5%(18/679),69.2%(193/279), and 24.4%(68/279) were at low, intermediate and high-risk of venous thromboembolism, respectively. The overall thromboprophylaxis rates in all patients, surgical patients, and patients only receiving chemotherapy were 61.7% (1131/1834), 83.3% (784/941), and 41.9% (117/279), respectively. The overall thromboprophylaxis rates differed significantly among different risk levels of Khorana score in all patients and surgical patients (P=0.002,P=0.016). There was no significant difference in thromboprophylaxis rate among different risk levels of Khorana score in patients receiving chemotherapy (P=0.060). However, in all patients and surgical patients, the distribution of three prophylaxis strategies (pure pharmacologic prophylaxis, pure mechanical prophylaxis, pharmacologic and mechanical prophylaxis) have no significant difference among three risk levels of Khorana Score (P=0.167, P=0.081). Conclusion Hospitalized cancer patients were at a relatively high risk of venous thromboembolism, but the prescription of thromboprophylaxis was not enough. Medical staff did not adjust prophylaxis strategies according to the risk level of venous thromboembolism. Hence, medical staff should evaluate venous thromboembolism risk of cancer patients, and adopt appropriate prophylaxis strategies to reduce the incidence of bleeding and venous thromboembolism.
		2020 Vol. 7 (3): 289-294 [Abstract] ( 317 ) HTML PDF (493 KB) ( 208 )

	295	Relationship between nutritional indicator and prognosis in advanced colorectal cancer undergoing chemotherapy
		He Yanling, Cai Hua, Zhang Junling, Su Jing, Yang Yuming, Peng Ya
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.009
		Objective To explore the relationship between body mass index, hemoglobin, serum albumin, and prognosis in advanced colorectal cancer patients undergoing chemotherapy. Methods From January 2013 to January 2018, 97 patients with stage Ⅲ-Ⅳ colorectal cancer who underwent palliative operation and postoperative chemotherapy in Hunan cancer hospital were analyzed retrospectively. To collect the clinical pathological data and the results of nutritional indicator pre-and post-chemotherapy, analyze the changes and the effects of nutritional indicator pre-and post-chemotherapy, on the survival time of patients according to the follow-up data. Results ①Before chemotherapy, there was a statistically significant difference in age between overweight group and normal weight group, and overweight group and low weight group (P<0.001）. The difference in Hb levels between different tumor sites was statistically significant (P=0.029). ②After chemotherapy, patients with low weight and low Hb increased significantly, while patients with normal weight and high Hb decreased, the difference was statistically significant (P=0.017, 0.007). ③Gender、the levels of post-chemotherapy Hb and ALB on the prognosis of patients were statistically significant (P<0.05）. Tumor differentiation and post-chemotherapy BMI are independent risk factors that affect the prognosis of patients with colorectal cancer (P<0.05）.Conclusion ①Advanced colorectal cancer over 60 years of age is more prone to low weight, and patients with colorectal cancer were more prone to have anemia. ②The proportion of patients with low weight and anemia increased after chemotherapy, and the incidence of malnutrition was higher in patients with advanced colorectal cancer after chemotherapy. ③Gender、the levels of post-chemotherapy ALB and Hb are the risk factors for the prognosis of patients with advanced colorectal cancer, but cannot independently predict the prognosis. Tumor differentiation and post-chemotherapy BMI are independent risk factor for the prognosis of patients with advanced colorectal cancer after chemotherapy.
		2020 Vol. 7 (3): 295-300 [Abstract] ( 389 ) HTML PDF (1029 KB) ( 233 )

	301	Expression and clinical significance of serine transporter SFXN1 in non-small cell lung cancer
		Jiang Huangang, Luo Yuan, Zhong Yahua, Zhou Fuxiang, Xie Conghua, Chen Gaili
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.010
		Objective To explore the expression of serine transporter SFXN1 and its relationship with stage and prognosis of non-small cell lung cancer. Methods Expression and prognostic implications of SFXN1 in lung cancer were analyzed by bioinformatics methods with databases including TCGA, Oncomine, HPA, UALCAN and Kaplan Meier plotter. Gene set enrichment analysis (GSEA) was used to explore the possible mechanism of SFXN1 regulating the oncogenesis, development and prognosis of lung cancer. Results Analysis with TCGA dataset showed that the expression level of SFXN1 in NSCLC was significantly higher than that in normal tissues. Statistics analysis of the gene sets in Oncomine showed that the expression of SFXN1 in lung adenocarcinoma was significantly higher than that in normal lung tissue, and the relative expression fold-change were 2.664 (P<0.001), 2.156 (P<0.001), 1.708 (P<0.001), 1.956 (P<0.001), 1.563 (P<0.001) and 1.653 (P<0.001), respectively. Compared with normal lung tissue, expression of SFXN1 protein in adenocarcinoma and squamous cell carcinoma was higher. The results of TCGA and UALCAN dataset showed that there was a positive relation between expression of SFXN1and clinical stage of lung adenocarcinoma；Kaplan Meier plotter analysis indicated that the expression of SFXN1 was negatively related to the prognosis of lung adenocarcinoma cases (median survival time, low expression group vs high expression group： 59.27 months vs 41.93months, P=0.0019). GSEA results suggested that the high expression samples of SFXN1 were enriched with E2F transcription factors, Myc signaling pathway, G2M checkpoint, mTORC1 complex, glycolysis, DNA damage repair and hypoxia related gene sets in lung adenocarcinoma. Conclusion SFXN1 is highly expressed in non-small cell lung cancer, and significantly related to the prognosis of lung adenocarcinoma patients. It may provide a new potential molecular marker and therapeutic target for the diagnosis and treatment of non-small cell lung cancer.
		2020 Vol. 7 (3): 301-306 [Abstract] ( 527 ) HTML PDF (4193 KB) ( 251 )

	307	321 cases of patients with malignant tumor body composition analysis
		Zhang Lingling Wang Lijiao, Du Hongzhen, Li Na, An Yonghui, Li Zengning
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.011
		Objective Investigate and analyze the body composition results of patients with malignant tumors, and explore the differences in body composition between different nutritional statuses and systemic inflammatory responses to provide a basis for improving the accuracy of individualized clinical treatment. Methods To collect patients with malignant tumors who were hospitalized in the Department of Oncology of the First Hospital of Hebei Medical University from October 2017 to December 2018, and conduct general data survey, body composition analysis, nutritional status assessment, and systemic inflammatory response within 24hours of admission Evaluation and laboratory related index testing. Compare the differences in body composition between different genders, ages, nutritional status, and systemic inflammation. Results 321 patients were included, including 186males and 135 females. The statistical differences in body composition parameters between men and women of different age groups, different BMI, and PG-SGA are mainly reflected in intracellular and extracellular water, protein, body fat mass, skeletal muscle mass, upper arm muscle circumference, etc. Only the extracellular water ratio was statistically different between the same sex and different age groups；the extracellular water ratio, body fat mass, visceral fat area, upper arm circumference, etc. between the three groups of mGPS were statistically different, and the Increase and show a downward trend. Conclusion Different genders, PG-SGA, BMI, and mGPS groupings have a greater impact on body composition of patients with malignant tumors, and as the nutritional status of patients deteriorates and the degree of inflammation increases, the deterioration of nutritional indicators related to body composition worsens. Correcting the malnutrition and inflammation of the patient as soon as possible can significantly improve the patients body composition and provide support for effective individualized clinical treatment.
		2020 Vol. 7 (3): 307-311 [Abstract] ( 358 ) HTML PDF (405 KB) ( 261 )

	312	Clinical value of postoperative PNI in prognosis assessment of gastric cancer patients
		Wu Ping, Du Renjia, Yu Yun,Ge Xiaosong
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.012
		Objective The prognostic nutritional index(PNI) is used as a prognostic factor in gastric cancer(GC). Through this retrospective study, we aim to investigate the relationship between the postoperative PNI and prognosis of patients with stage Ⅲ GC. Methods The subjects of this retrospective study were 91 patients who underwent resection for stage Ⅲ GC, according to the first chemotherapy after surgery, calculated nutrient comprehensive index, such as PNI, NLR, PLR, SII. Time-dependent receiver operating characteristic curve analyses were used to assess discrimination ability and to determine the optimal cut-off values. Results According to the optimal cut-off value, they were divided into the low PNI group (PNI<42.3) and the high PNI group (PNI≥42.3).According to the staging, they were divided into Ⅲa, Ⅲb and Ⅲc three substages. All the inflammation-based and/or the nutritional markers of patients of stage Ⅲ GC, multivariate analyses demonstrated PNI and staging were independent prognostic factors for OS (P=0.004 and P=0.009, respectively). Conclusion PNI is an independent prognostic factor for the prognosis of postoperative chemotherapy patients with gastric cancer, and low PNI and high sub-staging were associated with poor prognosis.
		2020 Vol. 7 (3): 312-316 [Abstract] ( 279 ) HTML PDF (738 KB) ( 262 )

	317	Effects of docosahexaenoic acid combined with cisplatin on proliferation and apoptosis of gastric cancer cell MGC-803
		Xu Liben, Wu Chaoyang, Wang Yuandong
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.013
		Objective Study the effects of docosahexaenoic acid combined with cisplatin on the proliferation and apoptosis of human gastric cancer MGC-803 cells, to analyze its possible mechanisms. Methods MTT evaluate the repression effect of DHA combined with DDP on MGC803 cells. calculate the IC50 and Q values. Observed apoptosis and morphology by DAPI, The cell cycle distribution and apoptosis rate were examined by flow cytometry.The expressions of survivin/NF-κB proteins were detected by immunohistochemical method. Results The proliferation of MGC803 cells was inhibited by DHA in a time-dose dependent manner. The inhibitory effect of combined group on the proliferation of MGC-803 cells were more obvious. Q>0.85, The DHA strengthen the cytotoxic effect of DDP on MGC803 cells. Drug treatment showed characteristics of apoptosis by using fluorescence microscopy.The apoptotic rate of DHA group, the apoptotic rate of combination group was higher than single drug group (P<0.05). The number of the combination group cells in G0/G1 phase increased (P<0.01), the number of G2/M and S phase cells decreased (P=0.01). The expression levels of survivin and NF-κB protein in combined group were lower than single drug group (P<0.05). Conclusion DHA can synergistic inhibit the proliferation of MGC803 cells, related to the regulation of cell cycle, down regulation of survivin and NF-κB protein expression, induction of apoptosis and enhance-ment of chemosensitivity.
		2020 Vol. 7 (3): 317-320 [Abstract] ( 274 ) HTML PDF (1078 KB) ( 213 )

	321	Clinical study on the changes of intestinal microflora and the end time of radiotherapy for cervical cancer
		Sheng Xiang, Zhu Ruijuan, Li Suyi
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.014
		Objective To investigate the effect of the end time of radiotherapy on intestinal microflora in cervical cancer patients, providing experimental evidence for clinical prevention and treatment of intestinal infections. Methods Based on the end time of radiotherapy, patients were divided into short-term group within 3months, and patients were divided into long-term groups with 3months or more of the end time of radiotherapy. For sequencing and analysis of 16S rRNA gene v4 sequences of intestinal microflora, we chose Illumina MiSeq high-throughput sequencing platform. In addition, bioinformatics analysis of the results was processed by using a collection of tools such as QIIME 2, and to predict the functional metabolism of intestinal microbiota by PICRUSt. Results There was no significant difference in intestinal microbial richness and diversity between the two groups (P>0.05)；In the structure of intestinal microbial community, there was a significant difference between the two groups (P<0.05)；In terms of intestinal microorganisms composition, 5 bacterial genera with significant differences were selected from the two groups, namely f_Barnesielaceae_g_uncl, g_AlistiPes, g_Bacteroides, g_Blautia, and g_Desulfovibrio. In terms of functional metabolism, it was found that the metabolism type of intestinal microbiota in patients in the Long-term group appeared to the up-regulation of colitis-related metabolic pathways. However, in the short-term group, the metabolic types of the intestinal microbiota were mainly normal metabolic pathways. Conclusion Through the analysis of intestinal microflora gene sequencing and microecological study in two groups of cervical cancer patients, it was found that the end time of radiotherapy had a certain effect on the diversity and metabolic function of intestinal microflora. For patients whose intestinal microflora was completed more than 3 months ago, 5 bacterial genera and 1 abnormal metabolic pathway were found in their intestinal microflora, while no significant changes were seen in STG. This is for clinical prevention and treatment of radiotherapy-related intestinal flora imbalance provide a microbiological basis.
		2020 Vol. 7 (3): 321-326 [Abstract] ( 306 ) HTML PDF (2213 KB) ( 216 )

	327	Correlation between PLR, NLR and the prognosis of patients with esophageal squamous cell carcinoma undergoing chemoradiotherapy or radiotherapy
		Li Ke, Li Tao, Lyu Jiahua, Xiao Ling, Liu Xiao
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.015
		Objective To investigate the effect between platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR) and the prognosis of patients with esophageal squamous cell carcinom(ESCC) a undergoing chemoradiotherapy or radiotherapy. Methods Retrospective analysis was performed for 143 cases with histologically confirmed ESCC that underwent chemoradiotherapy or radiotherapy from March 2012 to November 2017. The cutoff values of NLR and PLR were determined by ROC curve, and the patients were divided into high value group and low value group respectively. The chi-square test was used to compare the differences between different groups；Kaplan-Meier method was used to calculate the overall survival (OS)；log-rank test method was used for univariate analysis and Cox regression model for multivariate analysis. Results ROC curve analysis showed that PLR ＝189, NLR=3.55 were optimal cut-off values, 120 cases in low PLR group (<196.67), 23 cases in high PLR group (≥ 196.67)；96 cases in low NLR group (<3.55), 47 cases in high NLR group (≥ 3.55).The level of PLR and NLR before chemoradiotherapy or radiotherapy was not related to sex, age, tumor length, T stage, N stage and other clinicopathological features(P>0.05).Univariate analysis showed that T stage, N stage, treatment method, PLR and NLR are correlated with the overall survival of patients with esophageal squamous cell carcinoma before chemoradiotherapy or radiotherapy(P<0.05). Multivariate analysis revealed that the PLR, treatment method and T stage were identified as independent prognostic factors for the overall survival of ESCC patients(P<0.05), PLR is better than NLR in predicting the prognosis of esophageal cancer patients. Conclusion PLR and NLR might predict the prognosis of ESCC patients. PLR could be an independent prognostic factor for ESCC.
		2020 Vol. 7 (3): 327-332 [Abstract] ( 284 ) HTML PDF (1144 KB) ( 218 )

	333	Clinical observation on the effect of functional food on nutritional therapy of cancer patients
		Liu Meng,Shi Hanping, Zhou Hebing, Wan Chunfu, Fang Yu
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.016
		Objective To investigate a nutritional improvement effect of functional food on patients with malignant tumors. Methods A total of 248 patients with tumor admitted to 10 hospitals from April to October 2019 were selected and were divided into the control group (154 patients) and the functional group (94 patients). They all received radiotherapy or chemotherapy. Tumor patients in the functional group taking 30g of functional nutrition powder in the morning and evening were divided into four groups according to different durations： 9 in group A (15-30d), 25 in group B (31-60d), 44 in group C (61-90d), 16 in Group D (≥90d). The other 154 patients received radiotherapy or chemotherapy as the control group not taking functional food. During the experiment, relevant clinical indicators of patients were collected to evaluate the safety and patient compliance of functional food, and the physical strength, overall quality of life score, appetite score, white blood cell count, body weight, serum albumin level and other nutritional status indicators of each group before and after treatment were recorded and analyzed. Results Compared with the control group, the patients who took functional food had better nutrition indicators such as white blood cell weight and albumin, as well as physical life quality and appetite. After taking functional food for 1month, most of the tumor patients could maintain the normal levels of white blood cells and albumin. The average weight of the nutrition group was maintained at the pre-chemoradiotherapy level and higher than that of the control group (no statistical significance). The effect of the nutrition powder on the physical strength and overall quality of life of patients with gastrointestinal tumors was more significant. Conclusion The functional food can significantly improve the nutritional status of malignant tumor patients, good safety, can be used as an adjuvant anti-tumor therapy.
		2020 Vol. 7 (3): 333-339 [Abstract] ( 569 ) HTML PDF (2398 KB) ( 329 )

	340	Effect of lncRNA ANCR on proliferation and apoptosis of colorectal cancer cells and its mechanism
		Yue Yan,Tang Zhongsheng, Chen Hui
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.017
		Objective To investigate the effect of long chain noncodingRNA (lncRNA) on the biological behavior of colorectal cancer (CRC) cells and its mechanism. Methods Cancer and adjacent tissues of 50 CRC patients were collected.The expression levels of ANCR and forkhead box protein O1 (FOXO1) in tissues were detected by RT-qPCR and Pearson correlation analysis was performed. RNA pull-down and RNA immunoprecipitation (RIP) experiments were used to confirm whether ANCR could interact with FOXO1. ANCR and FOXO1 lentivirus were transfected into CRC cell line SW480 cells. The cells were divided into the control group (untransfected), NC group (transfected with lentiviral vector), ANCR group (transfected with ANCR over-expressed lentivirus), sh-ANCR group (transfected with ANCR knockdown lentivirus), FOXO1group (transfected with FOXO1 overexpressing lentivirus), sh-ANCR + sh-FOXO1group (transfected with ANCR and FOXO1 simultaneously inhibited lentivirus). RT-qPCR was used to detect the expression of FOXO1 after over-expression and inhibition of ANCR. 5-ethynyl-2′-deoxyuridine (EdU) labeling technology and flow cytometry were used to detect cell proliferation, cell cycle and apoptosis in each group. Western blot was used to detect the expression of B-cell lymphoma-2 (BCL-2), BCL2-Associated X Protein (BAX), cycle proteins cyclin D1 (cyclin D1) and Human P27 protein (P27 protein). Results Compared with adjacent tissues, the expression of ANCR in CRC tissues increased significantly, while the expression of FOXO1 decreased significantly (P<0.01). The expression levels of the two were negatively correlated (P<0.01). ANCR is able to bind and inhibit FOXO1 expression. Compared with the NC group, the number of cells in the sh-ANCR group and FOXO1group was reduced, the cells were arrested in the G0 / G1 phase, the number of apoptosis was increased, BAX and P27 were increased, and BCL-2 and cyclin D1 were reduced (P<0.05). Compared with the sh-ANCR group, the above indexes of the sh-ANCR + sh-FOXO1 group were reversed (P<0.05). Conclusion LncRNA ANCR expression is increased in CRC and regulates cell proliferation and apoptosis of CRC cells by regulating FOXO1 expression.
		2020 Vol. 7 (3): 340-346 [Abstract] ( 232 ) HTML PDF (4059 KB) ( 202 )

	347	Analysis of risk factors of sepsis in cancerous mechanical bowel obstruction
		Liu Xing, Zhang Wei, Ma Huaixing, Yu Haobin, Wu Dan, Liu Weiwei, Li Shiwei, Li Suyi
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.018
		Objective To explore the risk factors of sepsis in cancerous mechanical bowel obstruction. Methods The clinical data of 245 patients with the first cancerous mechanical bowel obstruction were analyzed retrospectively. The possible risk factors of sepsis in these patients were analyzed by unconditional logistic regression. Results The incidence of cancerous mechanical intestinal obstruction complicated with sepsis was 11.8% (29/245). Single factor analysis suggests that concurrent sepsis may be related to the patients body mass index<18.5kg/m2(P=0.033), PG-SGA evaluation of C grade(P=0.026), and serum levels of inflammatory factors such as blood C-reactive protein, procalcitonin, interleukin-6 levels increased (P<0.05), and no glucocorticoid treatment(P=0.039), the history of abdominal and pelvic radiotherapy (P=0.001). The results of multivariate analysis showed that body mass index<18.5kg/m2, PG-SGA evaluation of C grade and serum C-reactive protein, procalcitonin, and interleukin-6 levels increased, as well as no glucocorticoid treatment and the history of abdominal pelvic radiotherapy are cancerous mechanical bowel independent risk factors for obstruction complicated with sepsis (P<0.05). Conclusion Cancerous mechanical bowel obstruction complicated with sepsis is caused by many factors, The main risk factors were patients with body mass index<18.5kg/m2, PG-SGA grade C, serum C-reactive protein, procalcitonin, interleukin-6 levels increased, glucocorticoid-free treatment and history of abdominal pelvic radiotherapy.
		2020 Vol. 7 (3): 347-351 [Abstract] ( 303 ) HTML PDF (460 KB) ( 217 )

	352	Expressions of VEGF, TGF-β1 and PD-L1 in epithelial ovarian cancer and its clinical significance
		Hou Jianying,Zhu Wei
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.019
		Objective To investigate the expressions of VEGF, TGF-β1 and PD-L1 proteins in epithelial ovarian cancer, and to explore the association of the expressions of VEGF, TGF-β1 and PD-L1 with clinicopathological features. Methods Immunohistochemistry was used to detect the expressions of VEGF, TGF-β1 and PD-L1 in 46 cases of epithelial ovarian cancer, 20 cases of benign ovarian cystadenoma and 20 cases of normal ovarian, and analyzing the association of the expressions of VEGF, TGF-β1 and PD-L1 with the clinicopathological features. Results Immunohistochemistry showed that the positive expression rates of VEGF in epithelial ovarian cancer, benign ovarian cystadenoma tissue and normal ovarian tissue were 65.2% (30/46), 25.0% (5/20) and 15.0% (3/20), respectively. The positive expression rates of TGF-β1 in epithelial ovarian cancer, benign ovarian cystadenoma tissue and normal ovarian tissue were 82.6% (38/46), 30.0% (6/20) and 20.0% (4/20), respectively. The positive expression rates of PD-L1 in epithelial ovarian cancer tissues, benign ovarian cystadenoma tissue and normal ovarian tissue were 89.1% (41/46), 30.0% (6/20) and 25.0% (5/20), respectively. The positive rates of VEGF, TGF-β1 and PD-L1 in epithelial ovarian cancer tissues were higher than those in benign and normal ovarian tissues, with statistically significant differences (P<0.01). The expression of VEGF, TGF-β1 and PD-L1 in epithelial ovarian cancer was associated with FIGO staging and lymph node metastasis (P<0.05), and TGF-β1 was also associated with CA125 (P<0.05). In epithelial ovarian cancer,VEGF level was positively correlated with TGF-β1 (r=0.387, P<0.05)；VEGF level was positively correlated with PD-L1 (r=0.332, P<0.05)；TGF-β1 was positively correlated with PD-L1 (r=0.393, P<0.05). Conclusions The expressions of VEGF, TGF-β1 and PD-L1 were significantly up-regulated in epithelial ovarian cancer tissues and the above factors showing a positive correlation. The correlation with FIGO staging and lymph node metastasis suggested that VEGF, TGF-β1 and PD-L1may interact with each other through some mechanism to promote the progress of epithelial ovarian cancer, and the combined detection may guide the early diagnosis and treatment of epithelial ovarian cancer.
		2020 Vol. 7 (3): 352-358 [Abstract] ( 268 ) HTML PDF (1911 KB) ( 195 )

	358	Implementation and application of cancer nutrition diagnosis and intervention system
		Yu Kaiying, Feng Caiyun, Chen Yongbing, Shi Hanping, Liu Mingkun
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.020
		The incidence of malnutrition in cancer patients is high and have a negative effect on clinical outcome, which causes about 20% of malignant tumor patients directly die from malnutrition. Based on “screening-assessment-diagnosis-intervention”, a standardized nutrition care process should be addressed and applied at each institution involved in treating cancer patients, which is a basic measure for timely nutritional risk screening and accurate diagnosis of malnutrition. It is also the basic guarantee for applying scientific and rational nutritional treatment and improving the clinical outcome of cancer patients. The cancer nutrition diagnosis and intervention system is an equipment that integrates nutrition risk screening, comprehensive nutrition assessment, intelligent nutrition diagnosis and personalized nutrition therapy with the core of standardized nutrition care process. By the application of this system, the standardized nutrition diagnosis and intervention pathway can be realized；the complete nutrition-related data information can be obtained and shared in real-time；the efficiency of operations can be improved, which are significant to establish standardized nutrition care demonstration wards.
		2020 Vol. 7 (3): 358-361 [Abstract] ( 313 ) HTML PDF (426 KB) ( 371 )

	362	Research progress of flavonoids and their nanocrystals in tumor prevention and treatment
		Gao Hui, Fu Qiang, Sun Jie. Zuo Xuezh, Yao Ying
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.021
		The poor accessibility to tumor tissues and a range of adverse drug reactions are still great concerns for cancer therapies. Flavonoids are documented great potential in combating various types of cancer, while their safety profile and tumor site-specific action have not been evaluated thoroughly. Low solubility, rapid metabolism and poor absorption of dietary flavonoids limit their antitumor activity in vivo. Moreover, flavonoids may interact with other therapeutic agents resulting their bioavailability reduction, especially through biotransformation. Nanocarriers can alter pharmacokinetics and pharmacodynamic profile of incorporating drug. Moreover, nanocarriers are designed for targeted drug delivery, improving the bioavailability of poorly water-soluble drugs, delivery of macromolecules to site of action, and reducing ADRs. It has been shown the potential of flavonoids nano-formulations, especially quercetin, naringenin, apigenin, catechins and fisetin in the prevention and treatment of several types of cancer, both in vitro and in vivo studies. However, few clinical trials have yet to be performed. This review focuses on the impact of flavonoids nano-formulations on the improvement of their bioavailability, therapeutic and safety profile and will open new insights in the field of drug discovery for cancer therapeutics.
		2020 Vol. 7 (3): 362-365 [Abstract] ( 256 ) HTML PDF (659 KB) ( 280 )

	366	Home nutritional for cancer patients received radiation therapy
		Yang Liping, Gao Jin
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.022
		Patients with cancer were at high risk for malnutrition because of the physical or metabolic of the disease. The incidence of malnutrition which related to poor prognosis was up to 40%-80%. Radiation therapy, as one of the important methods of anti-tumor therapy, was widely used in clinic. While the curative effect was improved, the acute and chronic responses such as radiation mucositis, dysphagia, diarrhea, vomiting and so on, was accompanied. The patients were under-nourished, weight loss and metabolic disorder during and after the radiotherapy, which seriously affected the survival and prognosis. With the development of medical technology and consideration of many factors, such as physiology, psychology, society, economy and so on, home nutrition was widely concerned. With Standardized management of nutrition support team, completely management process and follow-up, we got the information for the nutritional status of patients timely by telephone, outpatient follow-up, home visit, e-mail and so on. Home nutrition improved the effectiveness of nutritional support and reduced the occurrence of adverse events. Home nutrition, as a continuation of in-hospital nutritional support therapy, can effectively maintain and improve the nutritional status of patients, and has certain social and cost-effective benefits.
		2020 Vol. 7 (3): 366-370 [Abstract] ( 348 ) HTML PDF (519 KB) ( 451 )

	371	Nutritional preparations for malignant bowel obstruction
		Sun Jie,Yao Ying
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.023
		The incidence of malignant bowel obstruction (MBO) in advanced tumors is about 5%-43%. The routine treatment methods of MBO include operation, medicine, nutrition therapy, gastrointestinal decompression, stent placement and traditional Chinese medicine. Due to the presence of digestive tract obstruction, most MBO patients are unable to eat or can only eat a small amount of food. As long as the gut is functioning, try to use enteral nutrition.The basic principle for the treatment of malnutrition should be to meet the patients energy needs“protein needs” fluid requirements and micronutrient requirements. Early nutritional therapy is very important for improving the quality of life and prolonging the survival period. Partial enteral nutrition (PEN)+ partial parenteral nutrition (PPN) or total parenteral nutrition (TPN) were mainly used for nutritional treatment. The types of enteral nutrition preparations and parenteral nutrition preparations that can be used by MBO patients were described in this paper.
		2020 Vol. 7 (3): 371-374 [Abstract] ( 268 ) HTML PDF (1084 KB) ( 250 )

	375	Strategies for nutritional treatment of malignant bowel obstruction
		Zhou Rui, Zhu Cuifeng
		DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.024
		Malignant bowel obstruction (MBO) that incite considerable distress for patients and their families was a common pre-terminal event for patients with advanced cancer. Reasonable nutritional treatment,including parenteral and enteral nutrition, might recover the intestinal function of MBO patients, correct the disturbance of internal environment, and significantly improve the general condition, so as to obtain the opportunity of palliative surgery or fistula, thereby improving the quality of life. Therefore,the standardized nutrition therapy strategy is of great significance to patients with MBO． However, to date,there are no guidelines for nutritional treatment for MBO patients．Therefore, this paper searched and analyzed the latest literature on nutritional treatment of MBO．After repeated discussions and modifications,we developed this nutrition therapy strategy. The guideline discussed the evidence and recommendations from the six aspects of nutrition diagnosis, nutritional treatment indications, treatment access, treatment pathways, nutrients, and efficacy evaluations for patients with malignant bowel obstruction. It has certain guiding significance for the treatment of clinical nutrition.
		2020 Vol. 7 (3): 375-379 [Abstract] ( 388 ) HTML PDF (467 KB) ( 295 )

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