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2021 Vol. 8, No. 1
Published: 2021-04-12
 
1 Progress review on tumor metabolic reprogramming and nutritional modulation therapy
1Gao Yun，1，2Yuan Haixin
Metabolic reprogramming, as one of the hallmarks of cancer, is widely observed in almost all tumorigenesis and development processes. Tumor cells meet their needs for bioenergy, biosynthesis, and redox balance by reprogramming nutrient acquisition and metabolism. In view of the key role of metabolic changes in tumorigenesis and development, targeting tumor metabolism has become one of the hottest topics in cancer drug development worldwide. In recent years, restriction of tumor metabolism by specific nutritional modulation has been widely studied and considered for clinical application. This approach, without impairing nutritional requirement for normal organs, restricts patients from specific nutrition that are essential for metabolic reprogramming in tumor cells. Nutritional modulation may sensitizes cells to chemotherapy, thus sheds light on efficient outcome of combined therapy strategy. This review will summarize the important tumor metabolic reprogramming events discovered in recent years. The progression of nutritional modulation treatments and preclinical and preliminary clinical experimental foundations of dietary and metabolic interventions in cancer therapy will be discussed.
2021 Vol. 8 (1): 1-5 [Abstract] ( 392 ) HTML PDF (1074 KB)  ( 377 )
6 Research progress on evaluation indexes and application of evaluation tools for postoperative intestinal intolerance in patients with esophageal cancer
1Zhang Ying, 2Jiang Guichun, 1Yu Ling
Esophageal cancer is one of the malignant tumors of digestive tract with high incidence and mortality worldwide, surgery is still the primary treatment for esophageal cancer, enteral nutrition（EN）is the first choice for postoperative nutritional support. After surgery, patients with esophageal cancer need to undergo a long time of EN support and gradually transition to oral feeding. After 3 to 9 months, the new diet pattern is reconstructed, and enteral nutrition support becomes an important stage for most patients to resume normal diet after surgery. Postoperative EN support in patients with esophageal cancer is prone to intestinal intolerance. It hinders the smooth implementation of nutritional support treatment. Some patients are forced to stop nutritional therapy. It has adverse effects on the quality of life and prognosis of patients. At present, there are no universally recognized and unified evaluation indicators and evaluation tools at home and abroad, and most researchers design their own evaluation tools according to the research objects, and the research objects are mainly in intensive care unit（ICU）, critically ill, premature infants and other infants, and there is a lack of evaluation tools for intestinal intolerance in patients with esophageal cancer. The selection of effective assessment indicators and tools can accurately and timely assess the occurrence and severity of intestinal intolerance, reduce the incidence of intestinal intolerance, and provide a reference for the improvement of clinical nutritional support programs. The paper reviews the assessment indicators and tools for intestinal intolerance in patients with postoperative EN support for esophageal cancer, aiming to provide reference for clinical medical staff to accurately and effectively assess intestinal tolerance.
2021 Vol. 8 (1): 6-10 [Abstract] ( 295 ) HTML PDF (992 KB)  ( 207 )
11 Potential applications of the gut microbiota in the diagnosis and treatment of colorectal cancer: recent advances and prospects
Wang Kewei, Dong Ming
Colorectal cancer is the malignant tumor of the digestive system with the highest incidence. With the faster pace of life and changes in diet, the incidence and mortality of colorectal cancer are also increasing year by year, seriously threatening human health. There are a large number of intestinal microbes in the human intestine. These microbes interact with host cells to regulate many physiological processes, such as energy harvest, metabolism and immune response. Abnormal changes in the internal or external environment of the host, such as unclean diet, unhealthy lifestyle, or the abuse of antibiotics, will destroy the homeostasis of the intestinal microbiota, trigger the imbalance of the intestinal flora, and then lead to the occurrence of many diseases including colorectal cancer. In recent years, the role of intestinal microbiota in the occurrence and development of colorectal cancer has attracted much attention. With the development of genomics technologies, research on the intestinal microbiota of colorectal cancer has achieved rapid development. More and more studies have shown that there will be an abnormal increase in the number of certain intestinal microbiota in patients with colorectal cancer; and improving the imbalance of intestinal flora can reduce the incidence of colorectal cancer and inhibit the progression of tumors. Therefore, intestinal microbes are expected to become biomarkers for colorectal cancer screening and prognosis prediction, and therapeutic targets. This article summarizes the latest progress in the application of gut microbiota in colorectal cancer in the past five years. This article provides an overview of recent research focusing on the application of gut microbiota in the diagnosis and treatment of colorectal cancer in the past five years and highlights the advances achieved.
2021 Vol. 8 (1): 11-16 [Abstract] ( 328 ) HTML PDF (1531 KB)  ( 282 )
17 Necessity and significance of constructing standardized radiotherapy nutrition demonstration ward
Lyu Jiahua，Li Tao
Radiotherapy has become the main means of integrated treatments for tumor. Malnutrition is one of the most common complications for patients with malignant tumors. It has been shown to have negative effect on cancer patients, such as reducing the tolerance and efficacy of their radiotherapy. Therefore, standardized nutritional therapy has important and positive significance for the treatment and prognosis of cancer patients. At the present time, many radiotherapists begun to explore how to carry out nutritional therapy for those patients, and gradually obtain theoretical achievements and practical experience. The concept of first⁃line nutritional treatment for cancer radiotherapy patients has been widely accepted by radiotherapy doctors, but the level of nutritional treatment carried out by different doctors in different regions and hospitals varies, and there are still many problems in the implementation of nutritional treatment in some regions and personnel. In addition, radiotherapy patients have special characteristics, such as long hospital stay, rapid changes of nutritional condition, and radiotherapy⁃related adverse effects. Its specific strategies and methods of nutritional therapy are not the same as other tumor patients, but also have their own characteristics. Therefore, it is necessary to establish standardized radiotherapy nutrition demonstration ward, which not only plays a demonstrative and guiding role for the other radiotherapy departments, and also effectively prevents the malnutrition of patients with tumor radiotherapy, promotes nutrition treatments. Furthermore, standardized radiotherapy nutrition demonstration ward can improve the safety and quality of life of patients, save health care costs and bring benefits to patients.
2021 Vol. 8 (1): 17-19 [Abstract] ( 345 ) HTML PDF (922 KB)  ( 268 )
20 Expert consensus on nutrition treatment for drug addicts
Drug addicts are generally suffering from malnutrition, and their comorbidities are relatively serious and their prognosis is poor, which poses a great burden to individuals and society. Drug withdrawal is a gradual process, massive consumption of nutritional results in various health problems, disruption of endocrine system, impaired detoxification function, substance and energy dysmetabolism. Nutritional therapy, as the foundation of drug treatment, helps to reduce the severity of withdrawal symptoms and accelerate health improvement. Most evidence⁃base treatment protocols have demonstrated the importance of nutrition to the recovery of addicts. Providing targeted nutritional and dietary interventions according to the different drug use and nutritional status of drug addicts is conducive to improving the detoxification effect, smoothly passing through the acute withdrawal period and even having a positive impact on the prevention of relapse. In order to fully implement the nutritional treatment theory of drug addiction medicine into withdrawal work, this expert consensus summarizes the relationship between drug withdrawal and nutritional diet, analyzes the physical and mental effects of different nutritional factors on drug abusers, standardizes the principles and steps of nutritional treatment for drug abusers, facilitates the application of drug abstinence prevention and control and other related health care personnel, and provides better services for drug abusers based on existing domestic and international research.
2021 Vol. 8 (1): 20-28 [Abstract] ( 363 ) HTML PDF (958 KB)  ( 150 )
29 Expert consensus on nutrition therapy for radiotherapy patients
Radiotherapy is one of the most important and cost⁃effectiveness treatment for malignant tumors. Although it can improve the nutritional intake and status of patients, its adverse reactions may lead to the occurrence of malnutrition or the deterioration of nutritional status. Malnutrition will have adverse effects on patients with malignant tumor undergoing radiotherapy. Standardized and effective nutritional treatment is of great significance, which is conducive to maintaining the weight of patients, reducing the adverse reactions of radiotherapy, and improving the completion rate and therapeutic effect of radiotherapy. The purpose of nutritional therapy for radiotherapy patients includes: ① to diagnose and treat malnutrition before, during and after radiotherapy; ② to reduce the adverse reactions of radiotherapy, to enhance the radiotherapy tolerance, reduce the unplanned interruption of radiotherapy, and improve the radiotherapy completion rate; ③ to increase the sensitivity of tumor cells to radiotherapy, improve the accuracy of radiotherapy, and improve the short⁃term and long⁃term efficacy of patients; ④ to improve the quality of life of patients.
2021 Vol. 8 (1): 29-34 [Abstract] ( 616 ) HTML PDF (1026 KB)  ( 364 )
35 The effect of sequential nutrition support on 5 congenital chylothorax infants
1Liang Lanqing, 1Ma lin, 1Qu Baolin, 1Cai Boning, 1Du Lehui, 1Meng Lingling, 1Feng Shengqiang, 1Liu Fang
To investigate quality of life and influencing factors in patients with nasopharyngeal carcinoma during tomotherapy. Methods The nasopharyngeal carcinoma patients who received tomotherapy from November 2017 to May 2019 were enrolled for the study in the Chinese PLA General Hospital. EORTC QLQ⁃C30 questionnaires were used to evaluate the quality of life, the factors affecting the quality of life of the nasopharyngeal carcinoma patients were screened by multivariate analysis. Results There were 91 patients who completed questionnaires and submitted successfully. Physical function, cognitive function, loss of appetite, nausea and vomiting, fatigue were correlated with the risk of malnutrition (P<0.05), pain and tumor staging was correlated (P<0.05). The correlation between global quality of life and concomitant diseases was statistically significant (P<0.05). After tomotherapy, the scores of global quality of life and functional areas of patients were lower than those before tomotherapy (P<0.05), and the scores of symptom areas were higher than those before radiotherapy (P<0.05). The degree of pain after tomotherapy was significantly correlated with oral mucositis (P<0.05). Loss of appetite, nausea and vomiting, insomnia, fatigue and constipation were correlated with acute pharyngoesophagitis (P<0.05). There was a significant correlation between the changes of total health level, physical function and nutritional status during radiotherapy (P<0.05). Conclusion The quality of life of the nasopharyngeal carcinoma patients decreased after tomotherapy. Quality of life and treatment compliance of the patients can be improved by reducing adverse radiation reactions, improving the nutritional status and controlling concomitant disease symptoms.
2021 Vol. 8 (1): 35-40 [Abstract] ( 307 ) HTML PDF (1558 KB)  ( 280 )
41 Clinical significance of three differential metabolites of unsaturated fatty acids in ascites of ovarian cancer
1Jing Yixin,1Liu Miao,2Kong Dan,1Liu Yu,2Zhao Shuang,1Yang Yongheng,1Jin Xiaoming
Objective To investigate the clinical significance of differential metabolites of three unsaturated fatty acids in ascites of ovarian cancer. Methods According to no chemotherapy and chemotherapy, chemosensitivity and chemotherapy resistance,37 cases of ovarian cancer ascites (including supernatant and precipitated cells) and 22 cases of ovarian cancer tissue samples were selected and divided into two groups for ultra-high performance liquid chromatography tandem time-of-flight mass spectrometry UHPLC-Q-TOF / MS analysis, combined with human metabolome database and multivariate statistical analysis, 46 differential metabolites were detected in each of the two groups. From the point of view of fatty acid metabolism, three differential metabolites involved in biosynthesis of unsaturated fatty acids (UFA) were screened.They are adrenic acid ,arachidic acid and dihomo-γ-linolenic acid(DGLA).Results The changes of metabolic peak intensity and the correlation between the coding genes of upstream and downstream related enzymes in the database [acyl-CoA thioesterase (ACOT code), desaturase (FADS code), etc.] showed that the changes of their metabolic levels were positively correlated with the expression levels of serum CA125 and other markers in patients. Conclusion Changes in the metabolic levels of arachidic acid,adrenic acid and DGLA in ascites of ovarian cancer may affect the prognosis of ovarian cancer to a certain extent.
2021 Vol. 8 (1): 41-47 [Abstract] ( 384 ) HTML PDF (3317 KB)  ( 560 )
48 A reticular meta‑analysis of the evaluation of the therapeutic effect of different treatment methods on colon cancer patients with liver metastasis
1Guo Yuntong, 2Xiong Yongqing, 1Cui Xiaolong, 1Huang He
Objective To evaluate the effects of four treatment options on the survival of patients with liver metastases from colon cancer. Methods Through searching PubMed, EMBASE, Cochrane Library, China Scientific Journals Network Publishing Library Weipu Chinese Science and Technology Journal Full-text Database, China Biomedical Literature Database, Wanfang Data Journal Paper Resources, China Scientific Citation Database and China Traditional Chinese Medicine Database, Clinical Trial Registration Institution Website and Google Academic Baidu Academic and other databases were searched for relevant literatures to obtain systemic chemotherapy, preoperative chemotherapy+surgery+postoperative chemotherapy, a clinical study on the treatment of liver metastases from colon cancer with four treatment options: surgery+postoperative chemotherapy, surgery+ postoperative chemotherapy+radiofrequency ablation. According to the inclusion criteria and exclusion criteria, the literature was screened and data were extracted. The quality of the literature was evaluated using Jadad tools, and stata was used. Net⁃like meta⁃analysis was performed with GeMTC software, and the publication bias was evaluated by funnel plot method, Begg′s Test and Egger′s Test, and the evaluation of heterogeneity among the included correlations was tested by Q test and I2 index. Results A total of 10 studies, 4 treatments, and 1026 subjects were included. The results of the net⁃like meta⁃analysis showed that the number of patients who survived the first year, the third year, and the fifth year after the treatment of preoperative chemotherapy+ surgery+postoperative chemotherapy was the highest among the four treatment options. Conclusion In the evaluation of the number of survivors, the clinical effects of preoperative chemotherapy+surgery+postoperative chemotherapy are better than the other three treatment options.
2021 Vol. 8 (1): 48-53 [Abstract] ( 269 ) HTML PDF (1298 KB)  ( 179 )
54 Nutrition education and counselling reduces critical weight loss rate during proton heavy ion therapy
Zhang Zhihong, Zhu Yu, Zhang Lijuan, Wang Ziying, Fu Zhonghua, Zhang Chong, Wan Hongwei
Objective Critical weight loss not only reduces quality of life, but also affects prognosis. This study validated its effectiveness in reducing the incidence of critical weight loss during proton and heavy ion therapy by implementing a guideline⁃based nutrition education and counselling program. Methods Patients during proton heavy ion therapy were recruited, and a historical control study design was adopted. The patients treated from Jan to Dec 2016 were used as the control group, and the patients from Jan to Aug 2018 as experimental group. The control group still received the original routine care, and the experimental group was given a nutrition education and counselling program based on the guidelines. Results A total of 713 cancer patients were included in the study, including 374 patients in the control group and 339 patients in the experimental group. The average age of the two groups was 54 and 53 years, and 45% and 49% were patients with head and neck cancer. The average weight loss during radiotherapy was 0.51 kg (0.75%) in the control group, and the rate of critical weight loss was 11.2% (42 cases); the experimental group lost 0.66 kg (0.90%), and the rate of critical weight loss was 9.4% (32 cases). After controlling the confounding factors of total radiation dose, radiation type, tumor location, concurrent chemotherapy, and gender, the risk of significant weight loss in the experimental group decreased by 34% (OR=0.66, 95%CI=0.48-0.91). Conclusion Guideline⁃based nutrition education and counselling programs can help improve the nutritional status of patients during proton and heavy ion therapy and effectively reduce the risk of significant weight loss
2021 Vol. 8 (1): 54-57 [Abstract] ( 329 ) HTML PDF (848 KB)  ( 329 )
58 Predictive value of preoperative C‑reactive protein‑albumin ratio for early recurrence in patients with radial gastrectomy
Wang Zhibang，He Kuan，Xie Yizhong
Objective To explore the predictive value of preoperative C⁃reactive protein⁃albumin ratio for early recurrence in patients with radial gastrectomy. Methods A total of 160 patients receiving radical gastrectomy in our hospital from May 2016 to May 2018 were retrospectively analyzed. According to whether recurrence occurred within 2 years of follow⁃up, patients were divided into recurrent group (n=34) and non⁃recurrent group (n=134). The clinical characteristics and related hematological indicators were compared between two groups. The efficacy of the above indexes in predicting early recurrence was analyzed. Results The tumor diameter (t=-2.326，P=0.021), the lymphovascular invasion rate(χ2=6.674，P=0.010)and lymph node metastasis(χ2=617.617，P<0.001) of the recurrent group were significantly higher than those of the non⁃recurrent group.However, there were no statistically significant differences between the two groups in age, body mass index (BMI), gender, surgical method, digestive tract reconstruction method and pathological type (P>0.05). With the comparison of preoperative hematological indicators between the two groups, it showed that systemic immune⁃inflammatory index(t=-2.951， P=0.004), neutrophil⁃lymphocyte ratio(t=-2.245，P=0.026), platelet⁃lymphocyte ratio(t=-2.885，P=0.004)and C⁃reactive protein⁃albumin ratio(t=-3.960，P<0.001)were significantly higher in the recurrent group than in the non⁃recurrent group. When the CAR threshold is set at 0.142, the specificity, sensitivity and AUC are 0.690, 0.962 and 0.719 respectively. Conclusion Preoperative CAR can effectively predict the risk of early recurrence after radical gastrectomy for gastric cancer.
2021 Vol. 8 (1): 58-61 [Abstract] ( 267 ) HTML PDF (1405 KB)  ( 204 )
62 The effects of knockdown AGK gene on proliferation and migration capacity of colorectal cancer cells
Gao Nana, Jia Pingping, Shi Hanping
Objective In order to investigate the effects of acylglycerol kinase(AGK) on proliferation and migration in HCT116 cells. Methods In this study, shRNA silencing lentivirus plasmid of AGK gene was constructed, and the second generation lentivirus packaging system was used to prepare and concentrate lentivirus venom and infect human colon cancer cell HCT⁃116 cell line.Then HCT⁃116 cell lines with knockdown AGK gene were screened for puromycin resistance.qRT⁃PCR and Western blotting were used to detect the mRNA and protein expression of AGK after knockdown. CCK⁃8 kit was used to detect the proliferation of AGK knockdown stable cell lines.The effect of AGK knockout on cell migration was detected by cells scratch assay. Results ShRNA silencing lentivirus plasmid of AGK gene constructed in this experiment can effectively knockdown endogenous AGK in HCT116.The mRNA and protein levels of AGK in HCT116⁃ASR⁃876 and HCT116⁃ASR⁃878 cells were significantly lower than those of wild⁃type cell lines (P<0.001).CCK⁃8 detection showed that AGK knockdown significantly reduced cell proliferation ability (P<0.05).The scratch test showed that AGK knockdown could significantly inhibit cell migration. Conclusion Knockout of AGK gene can significantly reduce the proliferation and migration abilities of HCT116 cells, which might provide a new potential target for targeted therapy of colorectal cancer.
2021 Vol. 8 (1): 62-66 [Abstract] ( 297 ) HTML PDF (2516 KB)  ( 179 )
67 Current status and influencing factors of barriers to enteral feeding of critically ill patients
Ma Yinqin, Rong Ning, Shi Rongmei
Objective To explore the status of intestinal feeding disorders in intensive care unit nurses from five hospitals, and to analyze the influencing factors. Methods This study was a cross⁃sectional survey. Using convenient sampling method, 180 ICU nurses from June 2016 to June 2019 in five hospitals were selected as subjects. The general data characteristics of nurses were collected using enteral feeding management questionnaires. The ICU patients with intestinal feeding disorder questionnaire were used to evaluate the status of intestinal feeding disorders. Univariate analysis was used to determine the effect of general characteristics of nurses on intestinal feeding disorders. Multiple linear regression analysis was used to determine the influencing factors of intestinal feeding disorders in ICU patients. Results The total score of the ICU nurses′ intestinal feeding disorder questionnaire was (61.13±12.76) points, and the scores of the three dimensions were (3.21±0.43) points. The three dimensions scored from high to low for patient EN supply (3.55±0.07) points, ICU care staff attitude and behavior (3.05±0.48) points and ICU resources (2.82±0.05) points. The four highest scores among the 19 items were: doctors prescribed a delay in starting the enteral nutrition (3.97±1.40) points, suspended enteral nutrition due to diarrhea (3.66±1.27) points, insufficient time for education and training how to best feed patients (3.65±1.38) points, waiting for the doctor/radiologist to read the chest X⁃ray to determine the correct position of the nutrition tube (3.56±1.23) points. EN⁃related training frequency (P<0.001), full⁃time ICU nutritionist (P=0.002) and hospital grade (P=0.021), EN manual (P=0.043) and professional title (P=0.001) are the effects of enteral feeding disorders in ICU patients factor. Conclusion Intestinal feeding disorders in ICU patients are affected by multiple factors. Therefore, the hospital department should strengthen nurse standardized and systematic feeding training, provide full⁃time nutritionist to ICU, and rationally allocate resources. In addition, an enteral feeding program is developed from the perspective of an evidence⁃based guideline and the patient′s subjective initiative is exerted.
2021 Vol. 8 (1): 67-71 [Abstract] ( 256 ) HTML PDF (876 KB)  ( 266 )
72 Investigation and analysis of tumor nutrition ‑related knowledge‑attitude‑practice among medical staffs in Hebei region
1Li Yao, 2Li Yitong, 3He Lili, 4Li Xiaoming, 5Wei Bingzhu, 6Cong Minghua
Objective To investigate the knowledge⁃attitude⁃practice(K⁃A⁃P) of cancer nutrition among 470 medical staffs in Hebei area, and analyze its influencing factors, to provide the scientific basis for make measures and further cancer nutrition work. Methods From December 2018 to June 2019, a self⁃designed questionnaire was used to investigate the K⁃A⁃P among 470 medical staffs in 13 Heibei hospital by the convenient sampling method, and statistical analysis based on collected scores. Results 481 questionnaires were sent out, 481 were recollected, finally 470 were effective, the effective rate was 97.77%. There were 240 doctors, 170 nurses, and 60 other medical staffs, the scores of overall K、A and P were 31.06±13.82、115.22±12.24 and 116.01±18.48, only 48.94%、53.19% and 46.17% of medical staffs were above the average. Spearman rank correlation showed, attitude was positively related with practice. Factors of knowledge score were sexual, occupation, academic, professional, teaching function, hospital nature and grade；factors of attitude score were occupation, academic, speciality, work type, teaching function、hospital grade；factors of practice score were occupation, academic, professional, working years, work type, hospital grade. Conclusion The medical staffs have a positive and rigorous attitude towards cancer nutrition in Hebei area, and it is necessary to strengthen the nutritional knowledge and nutritional behavior, by strengthening the construction of clinical nutrition and clinical nutritional department voluntary contact the superiority disciplines to optimize the work for cancer nutrition.
2021 Vol. 8 (1): 72-77 [Abstract] ( 224 ) HTML PDF (915 KB)  ( 304 )
78 Applications of early nutraceuticals support and homemade homogenate diet in patients with severe traumatic brain injury
1, 2Huang Xiaoming，1Du Zonghan, 1Lei Yan, 3Zheng Lihua，4Bai Yaqiang
Objective To discuss the effects of early nutraceuticals support and homemade homogenate diet in patients with severe traumatic brain injury(sTBI). Methods From January 2018 to June 2019, 84 sTBI patients were selected from the No.2 peoples′ hospital of Yibin and divided into nutraceuticals group and homemade homogenate diet (HDD) group randomly, patients in 2 groups were fed with off⁃the shelf nutraceuticals and HHD respectively, the nutritional indexes, adverse reactions/complications, Glasgow Coma Score (GCS) and hospitalization expenses were observed after 4 weeks. Results ① After nutrition support for 2 weeks or 4 weeks, hemoglobin (HB), albumin (ALB), prealbumin (PA), transferrin (TF), lymphocyte count (LYM), calf circumference (CC) and triceps skinfold (TSF) in nutraceuticals group were significantly higher than HHD group (besides TF after nutrition support 2 weeks, P<0.05). ②The incidence of pathoglycemia, diarrhea and total adverse reaction/complications in nutraceuticals group was significantly lower than HHD group (pathoglycemia: 14.3%：35.7%; diarrhea: 11.9%：40.5%; total incidence: 15.5%：25.0%, P<0.05). ③After nutrition support 2 weeks and 4 weeks, GCS in nutraceuticals groups were significantly higher than HHD group［2 weeks：(8.88±1.50) point (7.76±1.72) point；4 weeks：(10.26±2.40) point (8.86±2.14) point，P<0.05］. ④There was no difference of total hospitalization expenses and daily hospitalization expenses between 2 groups (P>0.05), daily nutrition support cost in nutraceuticals group was higher than HHD group ［(356.3±43.9) yuan (159.4±39.4) yuan, P<0.05］. Conclusion Compared with homemade homogenate diet, nutraceuticals support could be more beneficial to promote nutritional status of sTBI patients, reduce the incidence of insulin resistence, diarrhea or other complications, improve the prognosis of sTBI patients with possible better cost⁃effectiveness.
2021 Vol. 8 (1): 78-81 [Abstract] ( 230 ) HTML PDF (917 KB)  ( 240 )
82 The effect of sequential nutrition support on 5 congenital chylothorax infants
The effect of sequential nutrition support on 5 congenital chylothorax infants，1 Wang Wenqiao, 2 Wang Yuqi, 1 Long Qi, 1 Zhang Ting, 1 Chen Fei, 1 Chen Yuzhi, 1 Ma Ming 1 Department of Clinical Nutrition, the Children Hospital, Zhejiang University of Medicine/National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang, China; 2 Department of Respiratory Medicine, the Children Hospital, Zhejiang University of Medi‑ cine/National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang, China Abstract: Objective This research aims to explore the effect of sequential nutritional support on congenital chylothorax in infants, and to provide the basis for standardized treatment. Methods We collected five infants who were diagnosed with congenital chylothorax at Children′s Hospital of Medicine of Zhejiang University from January 2017 to December 2019, and retrospectively summarized clinical manifestation and analyzed the effect of the sequential nutritional support. Results A total of five infants with congenital chylothorax were recruited, including two males and three females. The average age of diagnosis was (75±17) days. All the 5 patients were characterized by cough and tachypnea, with 1 case accompanied by gastrointestinal symptoms (vomiting and diarrhea). The prenatal ultrasound detected pleural effusion in five patients, four of which presented with right pleural effusion, and the remaining one with bilateral pleural effusion. The average hydrothorax volume was (3.6±1.8) cm. All the five patients received sequential nutritional support (total parenteral nutrition to high MCT enteral nutrition) and recovered from conservative treatment. The height and weight of patients were both increased after treatment［ (61.9±2.2)cm vs (67.0±2.0)cm, t=23.3, P<0.001; (5.7±0.6)kg vs (7.2±0.6)kg, t=12.7, P<0.001, respectively］. The average values of length for age Z score（HAZ）、weight for age Z score（WAZ）、weight for length Z score（WHZ）before and after treatment were 1.45 and 1.48 (t=0.35, P=0.75), 0.004 and -0.39 (t=2.91, P=0.04), -0.83 and -0.59 (t=-0.58, P=0.59), and the incidence of malnutrition was 60% and 20%, respectively. The level of prealbumin in patients increased significantly after treatment［ (0.12±0.04) g/L vs (0.16± 0.02)g/L, t=-4.67, P=0.01］; while the change of albumin level had no statistical significance［(41.6±3.4)g/L vs (42.1±3.1)g/L, t= -0.75, P=0.49］. Through follow⁃up of two months, all the patients had no relapse of pleural effusion. Conclusion Patients with congenital chylothorax have high malnutrition risk. Nutritional support is an essential part of conservative treatment in patients with congenital chylothorax. The clinical symptoms and nutritional status of five cases were all improved after receiving sequential nutritional support. Key Words: Congenital chylothorax；Sequential nutrition treatment；Pleural effusion
2021 Vol. 8 (1): 82-86 [Abstract] ( 169 ) HTML PDF (888 KB)  ( 410 )
87 Research of Chinese medicine for activating blood circulation in regulating tumor metabolism
1Pang Haoyue，2Hu Kaiwen, 2Zhou Tian
Tumor metabolism is characterized by aerobic glycolysis with metabolic disorder of amino acid and lipid, which is the solid foundation of tumorigenesis. The special metabolic pattern can not only support the rapid growth of cancer, but also benefit tumor from the hypoxia and acidic surrounding environment, contributing to induce gene mutation, promote proliferation and metastasis and suppress immunity, which provides a proper condition to tumor development.Tumor metabolism becomes recent hotspot in research correspondingly. Blood stasis is a common syndrome of traditional Chinese medicine among advanced cancer patients. The pathological mechanism of blood stasis is similar to metabolic disorder. Thus, the mechanism of activating blood circulation in treating cancer was considered to be related to regulate tumor metabolism. Researches report that Chinese medicine for activating blood circulation could regulate the activities of metabolic enzymes and metabolic pathway⁃related proteins, affect mitochondrial function, reduce the intake of nutrients such as glucose in cancer cells, inhibit aerobic glycolysis, reduce lactic acid production, change the hypoxic environment of tumors, and inhibit angiogenesis, which provide evidence for the mechanism of Chinese medicine for activating blood circulation regulating tumor metabolism. In this paper, the mechanism of traditional Chinese medicine activating blood drugs in treating tumor was reviewed and discussed via regulating tumor metabolism, which contributes to elucidating the anti⁃tumor mechanism of activating blood drugs, provides a new direction for the further research and guide the application of Chinese medicine for activating blood circulation in tumor treatment.
2021 Vol. 8 (1): 87-92 [Abstract] ( 295 ) HTML PDF (1106 KB)  ( 293 )
93 Mechanism of bariatric surgery improve metabolism
Yi Xianhao, Zhu Shaihong, Li Weizheng, Tang Haibo, Zhu Liyong
Bariatric surgery is the most effective treatment for obesity, type 2 diabetes and related diseases. the mechanism of bariatric surgery improve metabolism have not been fully elucidated. The changes of gastrointestinal anatomy caused by bariatric surgery are the basis of postoperative metabolic improvement, it is generally believed that bariatric surgery reduces patients′ weight and improve metabolism by restricting food intake and reducing food absorption. In addition, increased secretion of the gastrointestinal hormones glucagon⁃like peptide⁃1 and peptide YY and decreased secretion of ghrelin can inhibit gastrointestinal peristalsis, decrease secretion of digestive juice, and decreased food intake. Postoperative bile acid increase and hepatointestinal circulation decrease. The decrease of firmicutes and the increase of proteobacteria and bacteroidetes in postoperative intestinal flora can cause the decrease of fat reserve and the change of fatty acid structure. The decreased secretion of adipokines leptin resulted in decreased food intake, while the increased secretion of adiponectin improved insulin sensitivity. The changes of central nervous system after operation can reduce the reactivity of food reward and reduce the intake of food. All these changes can improve postoperative metabolic status. Besides, the reason for metabolic improvement after surgery is not a single factor, but a result of mutual influence and common changes. This paper reviews the research progress on the mechanism of metabolic improvement after bariatric surgery.
2021 Vol. 8 (1): 93-98 [Abstract] ( 323 ) HTML PDF (984 KB)  ( 258 )
99 Research progress of fatty acid translocase CD36 in cancer progression
Zhang Qian, Ding Muyao, Yuan Shengtao, Sun Li
Cluster of differentiation 36(CD36) belongs to the scavenger receptor class B type 2 (SR-B2) and is also known as fatty acid translocase (FAT). CD36 is a transmembrane glycoprotein and widely expressed in multiple cell types. Because its extracellular domain interacts with diverse ligands, CD36 plays a key role in immunity, inflammation, angiogenesis, lipid metabolism and so on. In the field of cancer, more and more studies have shown that CD36 is highly expressed in some tumor cells and has an effect on the tumorigenesis and progression through different mechanisms. Especially when CD36 and its ligands ［such as thrombospondin-1(TSP-1), long chain fatty acid(LCFA), Toll-like receptors, collagen, etc.］are combined, it mediates the signaling pathway and has a great influence in tumor metastasis, tumor immunity, drug resistance and other process. In addition, CD36 is also expressed in tumor-associated stromal cells and immune cells and plays a different role in cancer progression. Currently, CD36 has been proposed as a biomarker in various types of tumors and indicates the poor prognosis. Based on the existing researches, this article reviews the structure, tissue distribution and ligands of CD36, and further discusses its effects and mechanisms in different types of tumors, in order to provide new perspectives for the development of anti-tumor drugs targeting CD36.
2021 Vol. 8 (1): 99-104 [Abstract] ( 786 ) HTML PDF (874 KB)  ( 570 )
105 Mechanism underlying antitumor effects of lactoferrin and its derivatives
1Zhang Wei, 2Liu Weiwei, 2Li Suyi 1
Lactoferrin has been extensively studied over the past 70 years, and its many biological functions are widely accepted by the scientific community. It is not only involved in iron storage and transport, but also has anti⁃microbial, anti⁃oxidation, anti⁃tumor, regulation of immune system function, etc. It is widely regarded as a new antibacterial and anticancer substance. Studies have shown that the exogenous treatment of lactoferrin and its derivatives can effectively inhibit tumor growth and reduce the sensitivity of tumor occurrence. Lactoferrin plays an anti⁃tumor role mainly through cell membrane destruction, apoptosis induction, cell cycle arrest and cellular immune response. However, the underlying mechanisms of the antitumor effects of lactoferrin are not fully understood. This paper reviews the antitumor effects and mechanisms of lactoferrin and its derivatives. On the basis of these mechanisms, a new strategy for the anti⁃tumor effect of lactoferrin and/or its derivatives is proposed, and the potential of lactoferrin and its derivatives in the field of anti⁃tumor research is discussed.
2021 Vol. 8 (1): 105-109 [Abstract] ( 405 ) HTML PDF (852 KB)  ( 360 )
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