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2021 Vol. 8, No. 4
Published: 2021-09-17
 
343 The effect of nutritional support on clinical outcome of esophageal cancer patients
Dai Tingting, Wang Zhiqiang, Hu Wen
Esophageal cancer is one of the most common cancers in China with its high incidence rate and low survival rate. Hence, among all esophageal cancer patients, the incidence of malnutrition is higher than any other types of cancer because of its physiological function and anatomical position. Medical nutritional therapy for patients with esophageal cancer has many advantages, such as reducing postoperative complications, enhancing postoperative recovery, maintaining body weight, preventing muscle loss, and decreasing mortality rates of malnourished patients around surgery. Patients with esophageal cancer may not benefit from routine nutritional therapy. However, when patients with esophageal cancer have moderate to severe swallowing obstruction, weight loss, nutritional risk or their food intake cannot reach more than 60% of the required caloric intake within 3-5 days, nutritional therapy should be then started. An early and timely nutritional therapy should be given to patients, which may improve their nutritional status and reduce the incidence of adverse clinical outcomes, and even benefit the survival of patients. However, the nutritional intervention rate of esophageal cancer patients is low and there is no universal consensus about when and how to properly assess an esophageal cancer patient. And doubts remain about the efficacy of immunonutrition treatment in those patients, with contradictory findings among different clinical trials. To provide clinical reference for improving clinical outcomes of esophageal cancer patients, this article reviews the nutritional status of esophageal cancer patients, the effects of medical nutrition therapy, and the clinical effects of treatment, especially the impact of immunotherapy on patients with esophageal cancer.
2021 Vol. 8 (4): 343-348 [Abstract] ( 326 ) HTML PDF (929 KB)  ( 446 )
349 Balanced nutrition is the basis of health, reasonable diet can prevent and inhibit cancer
1XuShufang,1MaoZhijin,2FuAdan
Dietary components are important for maintaining health and preventing disease. The three major macronutrients including carbohydrates, protein and fat not only supply energy to the body, but also play an important role in tumor nutrition metabolism.Proper amount and high quality carbohydrates can reduce the risk of cancer, and improve the diet with high quality protein supply, high dietary fiber and high ω⁃3 polyunsaturated fatty acids, which has significant benefits to improve the nutritional status and prognosis of cancer patients. Unhealthy diet and other factors can cause intestinal flora imbalance in the body, produce toxic metabolites, induce inflammation and immune imbalance, and promote the occurrence of tumors.A typical Western diet high in saturated fatty acids and refined carbohydrates can disrupt the intestinal barrier,metabolism and nutrition of cancer and an increased risk of cancer. The dietary pattern in southern China, which is characterized by more vegetables and fruits, more fish and shrimp aquatic products, regular consumption of dairy and soybean products, moderate consumption of cereals and meat and poultry, light cooking and less salt, represents the healthy dietary pattern in the east and deserves to be advocated. Following the balanced nutrition and advocating the rational diet are the key to maintaining a good intestinal microecology，preventing and controlling cancers and reducing the risk of all⁃cause mortality. This review will summarize the effects of nutrients intake and dietary patterns on human intestinal microecology as well as the incidence and prevention of cancer.
2021 Vol. 8 (4): 349-353 [Abstract] ( 307 ) HTML PDF (913 KB)  ( 437 )
354 Research progress on tumor metabolic reprogramming and its relationship with gut microbiota
Liu Fubin, Song Fangfang
Metabolic phenotypes are often altered during the process of tumor onset and development. This metabolic reprogramming mode not only comprises traditional nutrient sources (glucose, lipids, glutamine), but also lactate, acetate, ketone bodies and exogenous proteins can also be re⁃ingested and utilized by cancer cells. A healthy gut microbiota maintains homeostasis and normal intestinal function, and has important physiological significance in regulating host energy metabolism, promoting food digestion, and modulating immunity. However, the metabolites of the gut microbiota are capable of reshaping the nutritional microenvironment of tumors, forcing cancer cells to support their own proliferation and metastasis by changing their metabolic manners. In this paper, we systematically reviewed the nutrient sources involved in tumor metabolic reprogramming and its regulation by gut microbiota. On the one hand, tumor metabolism is reprogrammed, and tumor cells continuously absorb various nutrients from the surrounding environment to provide energy for their own growth and proliferation. On the other hand, the gut microbiota modulates the process of tumor metabolic reprogramming through its metabolites. At the same time, tumor metabolites possess a feed⁃back effect on the gut microbiota and then the intestinal ecological balance. It is particularly crucial to understand the mechanism of tumor metabolic reprogramming and reveal the interaction between the gut microbiota and tumor metabolism. This will provide a good theoretical basis for the exploration of effective metabolic targeted prevention and treatment strategy and potential drugs for cancer in the future.
2021 Vol. 8 (4): 354-361 [Abstract] ( 472 ) HTML PDF (1328 KB)  ( 671 )
362 Research progress on classification and prevention of clinical adverse reactions of enteral nutrition
Liu Jing, You Qian, Rao Zhiyong
With the wide application of enteral nutrition in clinic, the incidence of adverse reactions of enteral nutrition is gradually increasing. In order to improve the understanding of the related clinical personnel on the adverse reactions of enteral nutrition, improve the quality of nutrition treatment, reduce the adverse reactions caused by improper use, and ensure the effectiveness and safety of patients using enteral nutrition, objective to provide scientific basis for the standardized management of enteral nutrition for relevant medical staff. The related factors influencing the clinical outcome of enteral nutrition were extracted as the indicators of monitoring the clinical adverse reactions of enteral nutrition. The classification and preventive measures of enteral nutrition adverse reactions are summarized as follows. The types of enteral nutrition adverse reactions can be divided into sensory adverse reactions, gastrointestinal adverse reactions, allergic reactions and metabolic complications. Gastrointestinal malnutrition can be monitored through monitoring indicators such as taste discomfort, nausea, vomiting, abdominal distension, diarrhea, gastric retention, allergy, hyperosmolar dehydration, abnormal blood glucose, electrolyte abnormalities, and trace elements. In case of adverse reactions caused by enteral nutrition, we need to adjust the way of nutritional support treatment, adjust the feeding temperature, change the bolus to gravity drip or pump, and use the heater; Adjust the way of feeding and use pre digestion or short peptide preparation; adjust the dosage and concentration of enteral nutrition, from less to more, from thin to thick, reduce osmotic pressure, and gradually increase the feeding dose to relieve the symptoms of enteral nutrition intolerance, improve the nutritional level of patients, and prevent the occurrence of enteral nutrition adverse reactions.
2021 Vol. 8 (4): 362-365 [Abstract] ( 325 ) HTML PDF (855 KB)  ( 494 )
366 Chinese expert consensus on clinical use of multi⁃trace elements injection (2021)
The multi⁃trace elements injection could provide many trace elements for human body, such as iron, zinc, copper, manganese, cobalt, fluorine, iodine, selenium, molybdenum and chromium, and is widely used in patients who need parenteral nutrition. To further improve the clinician′s understanding of multi⁃trace elements injection and better guide the rational clinical application, we invite the national expert group members to formulate a consensus paper. The consensus paper is a composite of systematically reviewing pertinent literature, Chinese clinical practice, and multiple sessions of debate, discussion, and composition, with reference to guidelines from European Society for Parenteral and Enteral Nutrition (ESPEN) and American Society for Parenteral and Enteral Nutrition (ASPEN). This consensus is based on clinical research evidences and experts′ experience, which will provide references for the clinical use of multi⁃trace elements injection in critically illness, moderate to severe burn, perioperative period, cancer, elderly, dialysis, intestinal fistula and short bowel syndrome.
2021 Vol. 8 (4): 366-371 [Abstract] ( 850 ) HTML PDF (932 KB)  ( 726 )
374 Expert consensus on nutritional treatment for breast cancer patients
Breast cancer is the most common malignant tumor in women. Surgery, radiotherapy, chemotherapy, endocrine therapy and targeted therapy are common treatment methods. More and more evidence⁃based medicine evidences show that the nutritional status of patients with breast cancer is closely related to the treatment effect, the risk of recurrence, the risk of death and the quality of life. Proper nutritional treatment can not only help breast cancer patients maintain good nutritional status and living habits, increase treatment tolerance, improve treatment effect, improve quality of life, but also reduce the risk of recurrence and death of breast cancer patients. Nutritional monitoring and treatment of breast cancer patients should not be ignored, and should pay equal attention to anti⁃tumor treatment. Overnutrition is associated with a higher incidence in breast cancer patients than undernutrition. Overnutrition can lead to physical impairment, decreased quality of life, increased treatment⁃related adverse reactions, and persistent psychosocial problems. After the diagnosis of breast cancer, nutritional risk screening and nutritional assessment should be carried out, even if effective nutritional treatment measures are taken, and regular follow⁃up should be carried out throughout the disease process.
2021 Vol. 8 (4): 374-379 [Abstract] ( 572 ) HTML PDF (906 KB)  ( 951 )
380 A functional food enhances the anti⁃tumor efficacy of cisplatin
1YuYaying,2ZhangJie,3ChenZhewen,4ZhangYueming,5MiaoMingyong,6ShiHanping
Objective To explore the anti⁃tumor effect of a functional food and discuss the application prospect of functional food in tumor. Methods Lewis cells (murine lung adenocarcinoma line) suspension of 200 μl (1×107 /ml) at logarithmic growth stage was inoculated subcutaneously at the back of right hind limb of mice to construct Lewis subcutaneous tumor model of lung cancer. Mice were divided into the following four groups: control group and cisplatin group fed on standard diet, functional food group and functional food cisplatin group, 8 mice in each group, cisplatin group and functional food cisplatin group were intraperitoneal injected with cisplatin at 4 mg/kg body weight every other day, control group and functional food cisplatin group were injected with the same amount of normal saline. Experiments in the process of measuring weight and transplanted tumors in mice product every week, according to V=ab2π/6 (a for maximum diameter, b for minimum diameter) calculation, experimental destination for tumors had weighed and detection of serum albumin in mice, hind leg muscle circumference nutrition indicators, such as cells through the detection of mice spleen, related to the immune cells in serum and tumor tissue, ELISA kits IL⁃6+ and IL⁃10+ related cytokines, such as by immunohistochemical detection of tumor tissue microvascular formation. Results Compared with the control group, albumin and hindlimb muscle circumference were significantly increased in functional food group, but there was no difference in tumor volume and mass. Compared with the cisplatin group, the tumor volume and mass of the cisplatin group were significantly decreased, and the proportion of CD3+ CD4+ T cells, CD3+ CD8+ T cells and NK cells of tumor⁃bearing mice was significantly increased, with statistically significantdifferences. There was a decrease in the proportion of CD8+ IFN-γ +, CD8+ perforin+ T cells and IL⁃10+ cell, and a decrease in the subsets of inhibitory immune cells in the spleen, MDSCs and Treg, and in tumor tissues, but the differences were not statistically significant. There was no significant difference in IL-6+ cell and IL-10+ cell in each group. Conclusion Functional food can enhance the anti⁃tumor effect of cisplatin, which may be related to improving the nutritional status and regulating immunity of mice.
2021 Vol. 8 (4): 380-386 [Abstract] ( 345 ) HTML PDF (1744 KB)  ( 246 )
387 Effectiveness and safety of ketogenic diet in the intervention of polycystic ovary syndrome
1CuiGuangxia,1WuFengyun,2BaiLiran,3WangAili,4JiangBo,1BaiWenpei
Objective To assess the safety and effectiveness of ketogenic diet on improving polycystic ovary syndrome (PCOS) ⁃related symptoms in patients with overweight or obesity. Methods According to the inclusion and exclusion criteria, 18 PCOS patients were recruited in our study from December 2018 to May 2019, and were all carried out ketogenic diet intervention alone. The duration was one month for 8 patients and two months for the other 10 patients. All recruiters were followed up every day and rechecked monthly while the safety and effectiveness indexes were observed in the course. Results Of the eighteen patients who were treated with a ketogenic diet for one month, the body weight［（75.03±9.17）kg vs（69.64±8.74）kg］, fat mass ［（27.10±6.95)kg vs (23.22±7.05）kg］, BMI［（28.01±4.13)kg/m2 vs (25.99±3.90）kg/m2］, body fat rate［(35.68%±5.09%）vs （32.84%±6.11%)］, testosterone［(0.64±0.19)ng/ml vs (0.54±0.16)ng/ml］, LH/FSH［(1.74±1.03） vs （1.19±0.85)］ and fasting glucose［(5.36±0.81)mmol/L vs (4.62±0.53)mmol/L］were decreased dramatically. Of the ten patients who were treated with a ketogenic diet for two month, the body weight［（73.09±6.44)kg vs (65.35±5.58）kg］, fat mass［（25.54±4.99)kg vs（20.30±5.17）kg］, BMI［（27.21±2.95)kg/m2 vs (24.33±2.55) kg/m2］, body fat rate［(34.76%±4.64%) vs (30.77%±6.04%)］, and fasting glucose ［(5.40±0.92)mmol/L vs (4.61±0.55)mmol/L］were decreased dramatically. The median menstrual cycle decreased from 60 days to 44 days among the ten patients, which was statistically significant. The incidence of grade I adverse reactions during ketogenic diet treatment was 22.2%, mainly constipation, fatigue and hyperuricemia, which were significantly improved after rest and diet modification. Conclusion This Preliminary studies suggested that ketogenic diet intervention may be one of the safe and effective ways of body quality management for PCOS patients, and can normalize the menstrual cycle of PCOS patients.
2021 Vol. 8 (4): 387-392 [Abstract] ( 258 ) HTML PDF (929 KB)  ( 282 )
393 Investigation and analysis of knowledge⁃attitude⁃practice of oncology nutrition among Chinese medical staff
1,2 Zhang Xiaowei，1ChengXuejiao，2,3ShiHanping
Objective Investigation on nutritional K⁃A⁃P of medical staff in the oncology in order to enhance the attention of medical staff to nutrition therapy and provide a basis for the effective education of nutrition. Methods From June 2018 to December 2018, 30 provinces (autonomous regions and municipalities directly under the central government)，1972 hospitals and 6898 medical personnel were investigated by multi⁃center and observational study, and the results were analyzed statistically and compared with the survey results of cancer nutrition knowledge, attitude and behavior of medical staff in China in 2013. Results The scores of nutrition knowledge (K), pass rate (41.51%), excellent rate (20.65%), nutrition attitude (A), pass rate (97.94%), excellent rate (81.92%), nutrition behavior (P), (75.04±16.34) score, pass rate (85.41%), excellence rate 46.49%. There were significant differences in nutritional K score (P<0.01) and nutritional A score (P=0.034) between different sexes. There were significant differences in nutrition K score (P<0.01), nutrition A score (P<0.01) and nutrition P score (P<0.01).There were significant differences in nutrition A score (P<0.01) and nutrition P score (P<0.01) among different specialties. The top 3 ways to acquire nutrition knowledge are working practice learning, reading related books and periodicals, and studying in school before graduation. The scores of K,A and P of medical staff in 2018 were significantly higher than those in 2013（all P<0.01）. Conclusion The level of nutrition knowledge⁃attitude⁃behavior of medical staff in China has been improved obviously, and the status of general nutrition knowledge⁃attitude⁃behavior has been improved obviously, especially in the process of tumor nutritional therapy, there are still positive attitude and good nutritional therapy behavior, but the degree of mastering nutritional knowledge needs to be further improved, which is still the focus of nutrition education in the future.
2021 Vol. 8 (4): 393-397 [Abstract] ( 273 ) HTML PDF (893 KB)  ( 252 )
398 Investigation and analysis of sleep quality and related factors in patients with advanced cancer
Li Ning, Sun Rui, Yu Lei, Cong Minghua
Objective To investigate the sleep quality of patients with advanced cancer and its related influencing factors. Methods The self⁃made scale was used to investigate the general situation, nutritional status, exercise status and treatment of the patients. The Pittsburgh sleep quality index（PSQI）was used to investigate the sleep quality of the patients. The total score of sleep quality and the scores of each item were evaluated by t test. The abnormal incidence rate of sleep quality was analyzed by rank sum test. The multiple factors analysis of sleep quality was analyzed by ordinal Logistic regression and correlation analysis.. Cronbach α coefficient was used to estimate the internal consistency, and Spearman Brown formula was used to estimate the reliability. Results The scores of seven sleep quality components and the total score of PSQI of patients with advanced cancer were significantly higher than those of the normal sleep quality of healthy people in China (P<0.001). The internal consistency of PSQI scale applied to hospitalized patients with advanced cancer was high, with Cronbach α coefficient of 0.854. 61% of patients with advanced cancer had abnormal sleep quality. The incidence of sleep disorders in patients with decreased body mass index (BMI) (P=0.010), severe cancer pain (P<0.001), PS score 3 group (P<0.001), only symptomatic treatment (P<0.001), low fitness frequency (P<0.001) and less than 30 minutes of daily fitness (P=0.010) was significantly higher than that in other patients. Logistic regression analysis showed that pain (P<0.001) was a significant risk factor for abnormal sleep quality. Conclusions The incidence of abnormal sleep quality in hospitalized patients with advanced cancer is high, but the sleep quality is poor. The factors that affect the sleep quality of patients with advanced cancer are mainly related to the patient′s condition. According to these characteristics, individualized programs should be developed to improve the sleep quality of patients with advanced cancer, so as to improve the quality of life of patients with advanced cancer.
2021 Vol. 8 (4): 398-402 [Abstract] ( 304 ) HTML PDF (891 KB)  ( 267 )
408 The clinical practice of goal⁃directed nutrition pathway management in liver cancer operative patients combined with cirrho⁃ sis
Tang Xiaoli, Wang Haiqing, Yang Jie, Yu Jiaxiu, Zhao Ya, Lyu Jiahua, Cheng Yulin, Liu Meilin, Zou Jing, Wang Jing, Zhang Lixia
Objective To explore the effects of the implementation of the goal⁃directed nutrition on the nutritional status and postoperative rehabilitation of operative patients with liver cancer combined with cirrhosis from admission to discharge. Methods A cancer target nutrition team was established, a target nutrition pathway implementation list was formulated and applied throughout the whole progress of hospitalization, pre⁃operation, post⁃operation, discharge from hospital, and post⁃discharge.121 liver cancer patients operated before the implementation of goal⁃directed nutrition pathway management were included in the control group, and 126 patients operated after implementation were selected as the trial group. We evaluated the efficacy of intestinal nutrition efficacy real⁃timely and dynamically regulated the target nutrition in the experimental group. The changes of some data such as skeletal muscle, albumin, prealbumin on the 14th day after surgery, and the recovery time of intestinal function, postoperative complications, and the average hospital stay were compared between the two group. Results In the experimental group, there were no significant decrease in the skeletal muscle, the recovery time of intestinal function was significantly earlier, the level of albumin and prealbuminon was significantly better than that of the control group, and the incidence of bloating, diarrhea, ascites and infection was significantly lower than that of the control group. Conclusion The target nutrition management in the perioperative period delivered by the nutrition support group is a feasible nutrition implementation management mode for liver cancer patients, which can improve the nutritional status of patients and promote the rehabilitation of patients after surgery.
2021 Vol. 8 (4): 408-413 [Abstract] ( 223 ) HTML PDF (2778 KB)  ( 400 )
414 The study on expression of LYRM4⁃AS1 and independent risk factor in glioma
Wang Haiyue, Song Fei, Ren Peng, Xie Ying, Li Zengning, Luo Bin
Objective To evaluate the expression level and clinical significance of LYRM4⁃AS1 in glioma patients, as well as its related mechanisms. Methods RNA⁃seq data and clinical data of glioma patients were obtained from the TCGA database. The expression of LYRM4⁃AS1 in tumor and normal tissues was studied, and then the relationship between LYRM4⁃AS1 and the clinicopathological characteristics of patients with glioma was analyzed. Kaplan⁃Meier survival curve and Cox regression analysis were used to evaluate the clinical significance of LYRM4⁃AS1. The potential biological mechanism of LYRM4⁃AS1 was discussed through functional enrichment analysis. Results The study found that compared with normal tissues, LYRM4⁃AS1 was highly expressed in a variety of tumor tissues, and was related to WHO grade (P<0.001), IDH status (P<0.001), and 1p/19q coding loss (P<0.001), primary therapy outcome (P<0.001), EGFR status (P<0.001) and age (P<0.001). Prognostic analysis found that glioma patients with LYRM4⁃AS1 overexpressing had worse OS (HR=3.99, 95%CI=3.01-5.30, P<0.001), DSS (HR=4.00, 95%CI=2.98-5.37, P<0.001) and PFI (HR=2.68, 95%CI=2.13-3.38, P<0.001). Multivariate Cox regression found that LYRM4⁃AS1 was an independent risk factor for prognosis. Finally, functional enrichment analysis found that LYRM4⁃AS1 was related to inflammation and immune response. Conclusion LYRM4⁃AS1 may be a potential diagnosis, treatment and prognostic marker, and it may play a role in the occurrence and development of glioma through inflammation and immune response.
2021 Vol. 8 (4): 414-419 [Abstract] ( 240 ) HTML PDF (3532 KB)  ( 202 )
420 Clinical outcomes of the postoperative lung cancer with chylothorax receiving different nutritional treatments: a comparative study
1,2LiuHuan,1,3HuWen,3ChengYi,4ZhaoYixi
Objective To observe the clinical outcomes of three different nutritional treatments for the postoperative lung cancer with chylothorax patients, and to provide reference for future clinical treatment. Methods According to the inclusion and exclusion criteria, 45 patients were randomly divided into 3 groups: total parenteral nutrition (TPN) group, medium⁃chain triglyceride (MCT) diet group and low⁃fat (LF) diet group, with 15 patients in each group. After diagnosis of chylothorax, the patient immediately received nutritional treatment. Results Albumin levels of patients in the three groups were significantly lower at the time of diagnosis of chylothorax than at the time of admission (P<0.05). After nutritional treatment, albumin levels of patients in the three groups were significantly higher at the time of discharge than at the time of diagnosis, and the difference was statistically significant (P<0.05). The subjective comfort scores after 7 days nutritional treatment of the three groups were lower than that at the time of diagnosis of chylothorax (P<0.05), and the subjective comfort score of the TPN group was highest, followed by the LF group and TPN group in turn, with obvious difference between mutual groups (P<0.05). The amount of chest drainage after 7 days of nutritional treatment, the time to removal of drainage tube and ligation rate were no significant in the three groups (P>0.05).But the cost of nutritional treatment and the length of hospital stay after diagnosis in the MCT group and LF group were significantly lower than those in the TPN group (P<0.05). Conclusion The diet supplemented with MCT should be the first choice of nutritional treatment for the postoperative lung cancer with chylothorax patients.
2021 Vol. 8 (4): 420-423 [Abstract] ( 268 ) HTML PDF  (0 KB)  ( 140 )
424 Effect of immunonutrition therapy on tumor patients with sepsis
1 Zuo Dan, 2 Deng Wei, 2 Qin Chuan, 3Huang Biao, 3He Jie, 3Hu Dabi, 3 Yu Qin
Objective To investigate the clinical efficacy of immune enhanced enteral nutrition in patients with septic tumor. Methods From June 2018 to July 2020, the patients with sepsis in the intensive care unit of Chongqing Dazu District People′s Hospital were randomly divided into experimental group (n=30) and control group (n=30). The control group was given conventional nutrition treatment, and the experimental group was given immune enhanced compound enteral nutrition preparation on the basis of the control group. We also monitored and compared the serum albumin (ALB), calcitonin (PCT), C reactive protein (CRP), sequential organ failure assessment score (SOFA), D⁃lactate (D⁃Lac), diamine oxidase (DAO) and bacterial endotoxin in three groups of patients at three time points (0 weeks, 1 weeks, 2 weeks), and monitored intestinal function indexes of two groups of patients with intestinal dysfunction (diarrhea, abdominal distention, gastric retention). Pulmonary infection, ICU stay time and death cases. Results There were no significant differences in ALB, PCT, CRP, SOFA score, the number of cases of pulmonary infection, ICU stay time and death cases, and survival curve between the two groups (P>0.05). The indexes of intestinal function (DAO, D⁃Lac, endotoxin) in the experimental group decreased more significantly than those in the control group (P<0.05). The number of bowel dysfunction (diarrhea, abdominal distention, gastric retention) in the control group was more than that in the experimental group, with significant difference (P<0.05).Conclusion Early enteral nutrition therapy can improve the nutritional and inflammatory state of tumor patients with sepsis, and improve the therapeutic effect of tumor patients. Immune enhanced compound enteral nutrition therapy can improve the intestinal mucosal barrier function of tumor patients, and reduce the occurrence of intestinal dysfunction complications to a certain extent.
2021 Vol. 8 (4): 424-428 [Abstract] ( 208 ) HTML PDF (1049 KB)  ( 217 )
429 Effects of different food categories on gastrointestinal symptoms in gynecological tumor patients
Wang Yeting, Chu Chengmei, Zhang Feifei
Objective To investigate the dietary status of gynecological tumor patients and the occurrence of gastrointestinal symptoms, and to analyze the effects of different food categories on gastrointestinal symptoms in gynecological tumor patients. Methods According to the exclusion criteria, the self⁃designed questionnaires, including general data questionnaire, food intake frequency questionnaire, frequency of intestinal symptoms, were used to investigate dietary status and the occurrence of symptoms of digestive tract among 383 gynecological tumor patients and 344 healthy women. Results The gastrointestinal symptoms of 383 gynecologic tumor patients included 137 cases of chronic constipation (35.77%), 219 cases of diarrhea syndrome (57.18%), 153 cases of flatulence syndrome (39.95%), and 95 cases of chronic ulcer (24.80%) and hemorrhagic symptoms in 78 cases (20.37%), higher than healthy people. The diet types of gynecological tumor patients were mainly vegetables, fruits, cereals, beans, livestock and poultry, and eggs, and there were significant differences in the frequency of food categories between gynecological tumor patients and healthy people (P<0.001). There were some correlations between different food categories and gastrointestinal symptoms (P<0.001). Conclusion The gastrointestinal symptoms of gynecological tumor patients after radiotherapy are common. The symptoms of diarrhea are most significant. Different types of foods are associated with gastrointestinal symptoms.
2021 Vol. 8 (4): 429-433 [Abstract] ( 214 ) HTML PDF (881 KB)  ( 209 )
430 Application of global leadership initiative on malnutrition and patient⁃generated subjective global assessment in diagnosing malnutrition among cancer patients
1WuXiaolin,1HeDan,1GongHongxia,2HuangXiaoming
Objective To compare the application of global leader′s initiative on malnutrition (GLIM) and patient⁃generated subjective global assessment (PG⁃SGA) in diagnosing malnutrition among cancer patients. Methods From January 2019 to December 2020, 266 cancer patients were randomly selected from 416 Hospital of nuclear industry and assessed the incidence of malnutrition by GLIM criteria and PG⁃SGA respectively, and the consistency of two methods in diagnosing malnutrition was compared. Results ①The NRS 2002 score of cancer patients was (3.08±1.04), and the incidence of nutritional risk was 52.6% (140/266). There were significant differences of incidence of nutritional risk among different age groups, tumor types and tumor stages (P<0.05). ②Among the five phenotypes of GLIM, the incidence of weight loss, low BMI, muscle loss, decreased food intake/digestive dysfunction and disease/inflammatory burden were 44.0%, 17.3%, 41.7%, 69.2% and 38.7% respectively. The incidence rate of malnutrition assessed by GLIM criteria was 36.8%. There were significant differences of incidence of malnutrition among different age groups, tumor types and tumor stages (P<0.05). ③113 cases of cancer patients were diagnosed malnutrition by PG⁃SGA with the incidence rate 42.5%. There were significant differences of malnutrition incidence among different age groups, tumor types and tumor stages (P<0.05). The older age, the higher incidence of malnutrition, digestive system tumors were higher than other tumors, and the higher tumor stage, the higher incidence of malnutrition. ④The consistency of GLIM and PG⁃SGA was good to diagnose malnutrition stratified according to the general situation of tumor patients. A total of 90 cases of cancer patients was diagnosed malnutrition by GLIM and PG⁃SGA. The two methods were consistent in diagnosing malnutrition with the Kappa value 0.76. Conclusion The incidence of malnutrition and nutritional risk is high among cancer patients. There is a good consistency between GLIM and PG⁃SGA in diagnosing malnutrition, but more prospective studies are needed to confirm it.
2021 Vol. 8 (4): 430-407 [Abstract] ( 434 ) HTML PDF (949 KB)  ( 442 )
434 Research progress on nutrition assessment and nutritional status in children with hematological tumor
Li Peiyun, Wu Jing, Zhou Shiqiong
Hematological tumor is the most common type of tumor in pediatrics. Children with hematological tumor are always accompanied by malnutrition due to metabolic stress and accelerating growth. At the same time, various anti⁃tumor treatments may also exacerbate malnutrition. Malnutrition includes undernutrition which result in energy and nutrient deficiencies, and overnutrition due to excess energy intake. Severe malnutrition could influence therapeutic effect, raise the risk of complications, prolong hospital stays, decrease quality of life, and even increase the risk of death. Nutritional screening at the initial stage of disease diagnosis, comprehensive and accurate assessment of nutritional status, and individualized nutritional support are of great significance for improving the prognosis of children with hematological tumors. In this review, the recent progress on the selection of nutritional screening tools, the content of nutrition assessment, the association between malnutrition and the clinical outcomes in children with hematological tumor were discussed. This article was written with a view to increasing the concerns of medical staffs about the nutritional status in children with hematological tumors, providing clinical basis for the reasonable selection of nutritional screening tools and nutritional assessment content, and improving the quality of life and clinical outcome of malnourished children through early nutritional interventions.
2021 Vol. 8 (4): 434-438 [Abstract] ( 256 ) HTML PDF (884 KB)  ( 380 )
439 Food for special medical purposes in China：status quo and future development
Zhou Ziqi, Gou Maoqiong, Hu Wen, Rao Zhiyong, Shi Lei, Liu Yuan
By analyzing the development history of food for special medical purposes (FSMP) in China, the current situation and barriers of the industry were analyzed, and some exploratory suggestions were provided for reference to provide a certain basis for relevant policy formulation and industrial development trend. The enterprise manufacturer should timely understand and accurately interpret the policy, strengthen basic research, enhance innovation ability, meet the market demand with Chinese characteristics, pay attention to the effect feedback to optimize product design. It is recommended to establish a system to monitor the effects of FSMPs in clinical application as well as a hierarchical reporting system, so as to obtain real⁃world research data through the regulating system for the clinical application of FSMP products, and to produce high⁃quality real⁃world evidence to improve the post⁃market quality regulation system. The concept of FSMP among patients and their families should be promoted, to strengthen the publicity efforts, expand the channels of publicity, and deepen the understanding of consumers on its clinical effects. With demand⁃oriented policies and systems, the industry of FSMP that integrates various disciplines might provide new insights into the coordinated development of industries, universities, research institutes and end⁃users. The industry of FSMP will have to form a model that integrates product efficiency, patients′ satisfaction and enterprises′ profitability, and reduce the burden on individuals, families, medical institutions and even the government.
2021 Vol. 8 (4): 439-444 [Abstract] ( 287 ) HTML PDF (919 KB)  ( 1236 )
445 Progress in surgical treatment of cancer⁃associated bowel obstruction
Mao Yuantian, Chen Junqiang, Wu Xianghua
Cancer⁃associated bowel obstruction which often occurs in advanced abdominal and pelvic malignancies causes severe abdominal pain, nausea, vomiting, difficulty eating and other symptoms. It can seriously affect the patient′s quality of life and has been a tricky problem for clinicians.Surgical treatment that is one of the important methods mainly includes bowel stent placement and operation, and its primary purpose is to relieve the obstructive symptoms of patients and improve the quality of life. Among them, bowel stent placement has some characteristics of simple operation and less trauma, and can also provide a transitional period for some patients to undergo subsequent operation, but it may increase complications, such as perforation, survival time shortening or tumor recurrence increasing. Operation mainly includes palliative resection, radical resection, enterostomy, short⁃circuit operation. The postoperative time of intestinal patency and survival time of patients may be better than the application of intestinal stent, but it has some risks, such as postoperative anastomotic fistula and incision infection. There are still some controversies about the surgical treatment of cancer⁃associated bowel obstruction to choose bowel stent placement or operation, because of the advantages and disadvantages to the both methods. This article mainly review the application,the methods of treatment, the related risks of bowel stent placement and operation, and other therapies in cancer⁃associated bowel obstruction.
2021 Vol. 8 (4): 445-449 [Abstract] ( 261 ) HTML PDF (925 KB)  ( 221 )
450 Relationship between vitamin D and malignancy
1 Wu Zhezhe, 1 Chai Xiaoyan, 2 Sun Lijuan
Vitamin D is fat⁃soluble vitamin, which can stimulate the absorption of intestinal calcium and phosphate, absorb renal calcium and phosphate, and regulate the metabolism of bone minerals.Vitamin D deficiency easily leads to rickets, steomalacia, osteoporosis, and hand and foot spasm; excessive intake of vitamin D can cause vitamin D poisoning. It mainly comes from skin synthesis and food. Frequent sun exposure is the best source for obtaining adequate and effective vitamin D. Adults are often exposed to sunlight, generally do not develop vitamin D deficiency disease. In recent years, it has shown that vitamin D is related to the development of multiple malignant tumors. It is mainly focused on two points, one is to observe the relationship between vitamin D levels in different groups and malignant tumors, and the other is whether artificial vitamin D supplementation will change the incidence of malignant tumors. This paper reviews the relevant studies between vitamin D and various malignant tumors such as colorectal cancer and skin cancer, and the results found that there is a lack of sufficient evidence to support the body′s higher vitamin D levels, which can reduce the risk of malignant tumors. Since there are few studies on vitamin D and tumor development and development, and the results are vulnerable to climate, geographical environment, dietary factors, further prospective studies of large samples may be needed to further clarify the relationship between vitamin D and tumor.
2021 Vol. 8 (4): 450-454 [Abstract] ( 256 ) HTML PDF (2145 KB)  ( 351 )
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