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2022 Vol. 9, No. 1
Published: 2022-03-03
 
1 Nutritional therapy of patients with liver cancer in different disease states
1 Weng Min, 1 Dai Zhengyan,2 Wang Kunhua
Liver cancer is one of the most common malignant tumor that occurs in digestive system. Liver cancer is the 4th in morbidity and 2nd in mortality in China, which is a seriously endanger people's health and life. Malnutrition occurs throughout the entire course of liver cancer and the incidence of malnutrition is 80%. Patients often experience muscle protein consumption and decreased oxidation of branched amino acids, especially protei⁃energy malnutrition. For the diagnosis of malnutrition, liver cancer patients need routine nutritional diagnosis (nutrition screening, nutritional assessment and comprehensive assessment) when they are admitted to hospital, and follow the five⁃step principle for nutrition intervention. Optimal daily energy intake should not be lower than 30-35 kcal/kg, optimal daily protein intake should not be lower than 1.2-1.5 g/kg. For patients with hepatic encephalopathy need to reduce protein intake as appropriately and select protein sources reasonably. Patients with liver cancer with metabolic disorders and multiple organ dysfunction require multidisciplinary treatment and adhere to full nutritional management. Liver cancer patients which undergo liver resection, liver transplantation and interventional treatment have various nutritional problems, also accompanied by liver cirrhosis, hepatic encephalopathy, sarcopenia and sarcopenic obesity, individualized nutritional therapy in different disease states have a positive effect on the quality of life and prognosis of liver cancer patients. This article summarizes the nutritional therapy of patients with liver cancer in different clinical disease states to improve the prognosis of patients with liver cancer.
2022 Vol. 9 (1): 1-6 [Abstract] ( 458 ) HTML PDF (862 KB)  ( 494 )
7 The relationship between human microecology and radiotherapy
Miao Mingyong
The human microecology, especially the intestinal flora, is a new dynamic organ of the human body. The intestinal flora and its metabolites can directly act on the intestine or indirectly through the microbiota⁃gut⁃organ axis to act on the whole body tissues and organs and play an important role. The main physiological functions of human microecology include: regulating gastrointestinal movement and digestion, intestinal barrier, regulating immune homeostasis and inflammatory response, material metabolism, cell differentiation and turnover, and cognitive behavior. Radiotherapy can cause significant changes in the human microbiota, manifested as changes in flora diversity and abundance. These changes are not only related to the efficacy of radiotherapy, but also closely related to radiotherapy injury, complications and prognosis.At the same time, it was found that there were gender differences in radiation efficacy and injury, which was related to the gender differences of intestinal flora. Therefore, maintaining and adjusting the human microecological balance has an important impact on the efficacy of tumor radiotherapy and the prevention and treatment of radiation damage and complications. The application of microecological preparations (probiotics, prebiotics and postbiotics) and faecal microbiota transplantation play an obvious role in reducing tissue and organ damage caused by radiation, improving the curative effect of radiotherapy and reducing complications. As an adjuvant anti⁃tumor therapy, it shows a good clinical application prospect. Therefore, the optimal combination and application of disease⁃specific and individualized probiotics will be an important research direction in the future.
2022 Vol. 9 (1): 7-11 [Abstract] ( 267 ) HTML PDF (952 KB)  ( 350 )
12 Targeting cholesterol metabolism in cancer: opportunities and challenges
1 Peng Yu，2 Zhou Fuxiang，1 Liang Houjie
Cholesterol is an essential component of cell membrane. Abnormal cholesterol metabolism is not only closely related to cardiovascular diseases, but also closely related to the occurrence and progression of cancer. In the process of invasion and metastasis, cancer cells need a large amount of cholesterol to meet their rapid growth.Cholesterol is not metabolized into carbon dioxide and water and cannot be directly involved in energy supply. Cholesterol⁃derived metabolites participate in metabolic and immune regulation of tumor microenvironment in supporting cancer progression.To further promote tumor growth, intrinsic drivers in tumor cells or extrinsic factors in microenvironment can trigger changes in cholesterol metabolism during tumor progression. Furthermore, immune cells in the microenvironment also need cholesterol to maintain their normal functions.Simply lowering serum cholesterol may impair immune function and lead to tumor progression.The complex system of cholesterol regulation in microenvironment is formed by the grabbing of cholesterol by tumor cells and immune cells and the influence of cholesterol metabolites on each other. Therefore, to elucidate the characteristics of cholesterol metabolism in tumor cells and immune cells is the key to target cholesterol metabolism for cancer therapy. This review focuses on the effects of cholesterol metabolism changes on tumor cells and immune cells as well as the strategies of targeting cholesterol metabolism for cancer therapy. Combination therapy based on targeted cholesterol metabolism is expected to improve the efficacy of patients with certain characteristics of cholesterol metabolism.
2022 Vol. 9 (1): 12-17 [Abstract] ( 612 ) HTML PDF (979 KB)  ( 706 )
18 Malnutrition, characteristics of intestinal microbiota and application prospect of probiotics in cancer patients
1 Wang Ruiqi, 1 Zhang Lanwei, 2 Yu Zhuang
Malnutrition among cancer patients usually induces adverse consequences such as increased postoperative complications, decreased quality of life and increased mortality. According to the location of tumor, its incidence ranges from 40% to 80%, so it is very important to reduce malnutrition among cancer patients. Cancer⁃related malnutrition is closely related to the high energy consumption of the tumor itself, cancer⁃related anorexia and the side effects of cancer treatment. At present, tumor specific enteral nutrition agents do not eliminate the risk of malnutrition. Healthy intestinal microbes have high diversity, complex and stable structure, and are capable of resisting external environmental pressure. In contrast, non⁃healthy people show decreased bacterial diversity, loss of resistance to external environmental pressure, intestinal microecological disorders and other adverse conditions, such as cancer patients are often accompanied by the decline of intestinal microbiota, diversity and the proportion of beneficial bacteria in the process of disease,which seriously affects the immune ability and appetite of the body. As an important microecological agent, probiotics have the functions of regulating immune system function, energy metabolism and preventing colorectal cancer, which have a beneficial impact on human health. It can be predicted that probiotics may have a positive impact on the nutrition of cancer patients by regulating the structure and composition of intestinal microbiota, the secretion of cytokines, gastrointestinal peptides and other media, improving food intake and intestinal nutrition absorption. This paper systematically discusses the characteristics of intestinal microbiota and the potential role of probiotics in malnourished cancer patients, and puts forward the application prospect.
2022 Vol. 9 (1): 18-23 [Abstract] ( 276 ) HTML PDF (1055 KB)  ( 675 )
24 Guidelines for clinical diagnosis and treatment of cancer‑related sarcopenia
Chinese Society of Nutritional Oncology
Sarcopenia is a syndrome characterized by progressive and generalized skeletal muscle loss and hypofunction. Cancer patients have a higher incidence of sarcopenia due to hypercatabolic and low anabolic states. This sarcopenia associated with malignant tumors, called cancer⁃related sarcopenia, which not only affects the normal metabolism of body components in patients, but also reduces the efficacy of treatment, quality of life and survival of patients. Therefore, it has far⁃reaching significance for the long⁃term survival of patients to do a good job in nutritional screening and evaluation of cancer patients, timely detection of cancer⁃related sarcopenia, and effective intervention for the long⁃term survival of patients. Based on this, the Chinese Society for Nutritional Oncology organized experts to formulate this consensus, which contents mainly based on the current Chinese cancer⁃related sarcopenia diagnosis and treatment status, evidence published at home and abroad, combined with the experience and opinions of experts in the fields of clinical, pharmaceutical, nutrition, nursing, etc., used the European Society of Cardiology (ESC) evidence grading and recommendation intensity standards, and focused on the screening, diagnosis, evaluation, treatment of malignant cancer⁃related sarcopenia for analysis, discussion and summary. Finally, the clinical diagnosis and treatment guidelines for cancer⁃related sarcopenia were formulated for clinicians to provide a reference basis for standardized diagnosis and treatment.
2022 Vol. 9 (1): 24-34 [Abstract] ( 780 ) HTML PDF (1283 KB)  ( 1150 )
35 Expert consensus on nutritional therapy for patients with pancreatic cancer
Chinese Society of Nutritional Oncology，Chinese Society for Parenteral and Enteral Nutrition
Pancreatic cancer is a highly malignant wasting disease, 80％- 90％of pancreatic cancer patients experience emaciation, fatigue, and weight loss in the early stages of the disease. Advanced neoplasms are associated with poor fluid mass and may present with electrolyte disturbances, hypoproteinemia, and changes in blood glucose. Patients with pancreatic cancer need routine nutritional screening and evaluation, and actively give nutritional treatments. Principles of nutritional therapy for pancreatic cancer: ① Enteral nutrition is the first choice for patients with malnutrition and normal gastrointestinal function.②Postoperative nutrition treatment can be given according to the concept of accelerated rehabilitation surgery to help patients enter the next stage of treatment.③ Nutritional therapy is recommended for pancreatic cancer patients with stable vital signs and autonomic eating disorder who have received radiotherapy and chemotherapy. In principle, systemic nutritional therapy should not be considered for patients with unstable vital signs and multiple organ failure.④ Patients with obstruction and pancreatic cancer who cannot eat orally need parenteral nutrition.
2022 Vol. 9 (1): 35-38 [Abstract] ( 694 ) HTML PDF (819 KB)  ( 681 )
39 Study on the correlation between nutrition‑related symptoms GLIM and quality of life in patients with colorectal cancer
1 Ruan Xiaoli, 1 Rena Nakyeyune, 1 Shen Yi, 2, 3 Shi Hanping, 1 Liu Fen
Objective To evaluate the impact of nutrition⁃related symptoms on the nutritional status and its correlation with Global Leadership Initiative on Malnutrition (GLIM) and quality of life. Method A total of 2063 patients with colorectal cancer re⁃ cruited in multicenters from June 2013 to December 2018 were included in this study, all of them completed malnutrition diagnosis and evaluation of quality of life. Logistic regression analysis was used to evaluate the impact of nutrition⁃related symptoms on nutri⁃ tional status, and Spearman correlation analysis was used to assess the correlation between nutrition⁃related symptoms and GLIM, quality of life. Result A total of 875 patients (42.4%) had at least one nutrition⁃related symptom, and the highest incidence was no appetite (14.5%), 948 patients (45.5%) were malnourished. The median of QLQ⁃C30 score of 66.7.The results of Spearman correla⁃ tion analysis showed that except for mouth sores, no appetite (r=0.246, P<0.001), nausea (r=0.137, P<0.001), vomiting(r=0.154, P< 0.001), constipation (r=0.124, P<0.001), dry mouth (r=0.138, P<0.001), feel full (r=0.150, P<0.001), pain (r=0.175, P<0.001), the score of nutrition-related symptoms (r=0.337, P<0.001) were correlated with malnutrition according to GLIM criteria. The associa⁃ tion between malnutrition diagnosed by GLIM criteria and diarrhea (r=0.072, P=0.001), change in taste (r=0.088, P<0.001), change in smell (r=0.070, P=0.001), problems swallowing (r=0.049, P=0.025) was low, although statistically significant. The QLQ⁃C30 score was correlated with nutrition⁃related symptoms (except diarrhea) (no appetite:r=0.309, P<0.001; nause: r=0.209, P<0.001; vomiting: r=0.189, P<0.001; constipation: r=0.138, P<0.001; mouth sores: r=0.077, P<0.001; dry mouth: r=0.157, P<0.001; change in taste: r=0.157, P<0.001; change in smell: r=0.119, P=0.001; problems swallowing: r=0.104, P=0.025; feel full: r=0.115, P<0.001; pain: r=0.154, P<0.001). No appetite, vomiting, constipation, diarrhea, dry mouth, feel full and pain were independent risk factors for malnutrition after adjustment for age, type of cancer, stage, organ metastasis, and nutritional treatment (no appetite: HR=3.152, 95%CI=2.335-4.255, P<0.001; vomiting: HR=2.877, 95%CI=1.648-5.023, P<0.001; constipation: HR=1.796, 95%CI=1.283-2.516, P=0.001; diarrhea: HR=1.549, 95%CI=1.096-2.190, P=0.013; dry mouth: HR=2.252, 95%CI=1.454-3.488, P<0.001; feel full: HR= 3.317, 95%CI=2.102-5.235, P<0.001; pain: HR=2.346, 95%CI=1.628-3.379, P<0.001). Conclusion The prevalence of nutrition⁃re⁃ lated symptoms in patients with colorectal cancer is high, and it is related to the nutritional status and quality of life. Early assessment of the occurrence of nutrition⁃related symptoms is beneficial to take appropriate treatment to improve the nutritional status and quali⁃ ty of life of patients.
2022 Vol. 9 (1): 39-48 [Abstract] ( 260 ) HTML PDF (1394 KB)  ( 445 )
49 An experimental study of curcumin inhibiting the malignant phenotype of renal cell carcinoma by regulating the TLR4/NF‑κB signaling pathway
Lin Changwei, Yuan Xinzhu, Yuan Zujun
Objective To explore curcumin inhibiting the malignant phenotype of human renal cell carcinoma (RCC) by regulating the Toll⁃like receptor 4/nuclear factor⁃κB (TLR4/NF⁃κB) signaling pathway. Method The HK⁃2, 786⁃0, and ACHN cell lines cultured in vitro were divided into control group, curcumin group, TLR4/NF⁃κB signaling pathway inhibitor group (TAK⁃242 group). The curcumin group was divided into curcumin 10, 20, 40 μmol/L subgroup. CCK⁃8 method, Annexin V⁃FITC/PI staining, scratch test, and Transwell chamber test were used to detect ability of cell proliferation, apoptosis, migration and invasion; ELISA method was used to detect cell interleukin⁃1β (IL⁃1β), interleukin⁃6 (IL⁃6) and tumor necrosis factor⁃α (TNF⁃α) content; Western blotting method was used to detect the expression of TLR4, NF⁃κB p65, B cell lymphoma⁃2 (Bcl⁃2), BCL2⁃Associated X (Bax), and matrix metalloprotein⁃9 (MMP⁃9). Result Curcumin had no toxic effect at concentrations below 40 μmol/L; in renal cancer cell lines 786⁃0 and ACHN, Compared with the control group, curcumin 10, 20, and 40 μmol/L subgroups can significantly inhibit cell proliferation, migration and invasion, and promote cell apoptosis; IL⁃1β, IL⁃6 and TNF⁃α, TLR4, NF⁃κB p65, Bcl⁃2, MMP⁃9 levels decrease, and Bax levels increase, The differences are statistically significant (P<0.05). Conclusion Curcumin can inhibit the proliferation, migration and invasion of renal cancer cells and promote cell apoptosis by inhibiting the TLR4/NF⁃κB signaling pathway.
2022 Vol. 9 (1): 49-55 [Abstract] ( 229 ) HTML PDF (3289 KB)  ( 298 )
56 Study on enhanced recovery of pre‑rehabilitation of intestinal function in patients with colorectal cancer complicated with ileus
Gong Guanwen, Cheng Hui, Ge Miaomiao, Liu Jiang, Pan Huafeng, Jiang Zhiwei
Objective To observe the effect of pre⁃rehabilitation of intestinal function on colorectal cancer patients with ileus. Method 64 patients with colorectal cancer complicated with intestinal obstruction admitted to Jiangsu Hospital of Traditional Chinese Medicine from January 2018 to October 2021 were selected and divided into the catheter group (28), the stent group(16) and the control group (20). The catheter group received transanal decompression combined with early enteral nutrition, and operation after 5⁃7 days. The stent group received stent decompression, combined with enteral nutrition, functional exercise, combined with chemotherapy followed by surgery. The control group received surgery immediately after admission. The rate of laparoscopy, rate of primary anastomosis, operation time, fever rate, incision infection rate, postoperative exhaust time and postoperative hospital stay were observed. The inflammatory, nutritional and immune indexes of the three groups were compared. Result At first admission, there was no significant difference in all indexes among the three groups (P>0.05). After pre⁃rehabilitation, the ASA and NRS 2002 scores of the stent group were lower than those of the control group (P<0.05), but there was no significant difference between the catheter group and the control group (P>0.05). ASA scores of the two groups were different before and after pre⁃rehabilitation (P<0.05). The success rate of laparoscopic surgery and primary anastomosis in the catheter group and the stent group was higher than that in the control group (P <0.01), but there was no significant difference in the proportion of radical surgery among the 3 groups (P>0.05). The postoperative fever rate and incision infection rate in the two groups were lower than those in the control group (P<0.05), and the operation time in the stent group was shorter than that in the other 2 groups (P<0.05). The postoperative exhaust time in stent group was significantly shorter than that in control group (P<0.05). The length of postoperative hospitalization in both groups was significantly shorter than that in control group (P<0.05). CRP, WBC, N, IL⁃6 and TNF⁃α in catheter group and stent group were significantly lower than those in control group (P<0.01). The counts of CD3+ , CD4+ and CD8+T cell in the two groups were higher than those in the control group (P <0.05), but there was no significant difference in CD4+ /CD8+ among the 3 groups (P>0.05). Conclusion Pre⁃rehabilitation of intestinal function can effectively improve the quality of surgery, reduce inflammation, improve nutritional and immune status of patients, reduce infectious complications, and speed up the recovery of patients.
2022 Vol. 9 (1): 56-60 [Abstract] ( 226 ) HTML PDF (865 KB)  ( 229 )
61 Expression of c‑MET, EGFR and HER‑2 in gastric adenocarcinoma and their correlation with clinicopathological features and prognosis
Nian Rui，Li Wanjun，Li Weihua
Objective To investigate the expression of c⁃MET, EGFR and HER⁃2 in gastric adenocarcinoma and their correlation with clinicopathological features and prognosis. Method From January 2016 to January 2018, 87 patients with gastric adenocarcinoma who underwent radical gastrectomy from the 3201 Hospital Affiliated toMedical College of Xi'an Jiaotong University were selected as the research objects.The expressions of c⁃MET,EGFR and HER⁃2 proteins in tissues were detected by immunohistochemical method, and their correlations with Ki⁃67 protein and clinicopathological features were analyzed.They were dividedinto positive group and negative group (37 casesin c⁃MET positive group and 50 cases in c⁃MET negative group). There were 33 cases in EGFR positive group and 54 cases in EGFR negative group. There were 39 cases in HER⁃2 positive group and 48 cases in HER⁃2 negative group.The recurrence free survival rate and overall survival rate were compared among the groups. ResultIn the pathological characteristics of the patients, the difference in the degree of differentiation,TNM stage, lymph node metastasis, distant metastasis, and tumor thrombus positive rate of c⁃MET, EGFR and HER⁃2 protein was statistically significant(P<0.05). The positive expression of c⁃MET, EGFR and HER⁃2 protein was positively correlated with the positive expression of Ki⁃67 protein (r=0.319, 0.338, 0.374;P<0.05).After 3 years of follow⁃up, 31 patients died andthe survival rate was 64.37%; 31 patients relapsed, and the recurrence⁃free survival rate was 64.37%. The median survival time of c⁃MET, EGFR and HER⁃2 positive group were 19.95, 19.28 and 21.49months, andthe median survivaltime of negative group were 33.84, 33.10 and 33.26months,respectively.The median recurrence⁃free survival time of c⁃MET, EGFR and HER⁃2 positive group were 14.59, 13.84 and 15.35months, and the negative group were 27.83, 27.37 and 27.57 months. The recurrence⁃free survival rate and overall survival rate of c⁃MET, EGFR and HER⁃2 positive group were lower than those of negative expression group (P<0.05). Positive EGFR protein is an independent prognostic factor affecting the overall survival of gastric adenocarcinoma (RR=4.278, 95%CI=2.099-8.713, P<0.05). Conclusion The expression of c⁃MET, EGFR and HER⁃2 protein in gastric adenocarcinoma was related to the degree of differentiation, depth of invasion,TNM stage, lymph node metastasis, distant metastasis and tumor thrombus. Patients with positive expression of c⁃MET, EGFR and HER⁃2 protein had higher recurrence rate, lower relapse free survival rate and overall survival rate, and worse prognosis. Positive EGFR protein is an independent prognostic factor that affects the overall survival of patients.
2022 Vol. 9 (1): 61-65 [Abstract] ( 185 ) HTML PDF (1090 KB)  ( 221 )
66 A cross-sectional study of changes of vitamin levels in patients with esophageal cancer receiving chemotherapy
Liang Renpei, Luo Liyun, Lai Zhangchao, Zhang Jiangling, Yang Aiwu
Objective To study the changes of vitamin levels in patients with esophageal cancer during chemotherapy. Method The clinical data of 243 patients with esophageal cancer who received chemotherapy in the No.910 Hospital of PLA from July 2017 to September 2020 were selected. The levels of nine vitamins[A，B1，B2，B6，B9(folic acid)，B12，C，D，E], hematological indexes and body mass index (BMI) in patients with esophageal cancer were measured before and after two cycles of chemotherapy. The changes of the number and average level of 9 vitamin deficiency patients in patients with esophageal cancer after two cycles of chemotherapy were compared. Pearson correlation score was used to analyze the correlation between the differences of various vitamin levels and the changes of BMI before and after chemotherapy. Result the age of 243 patients ranged from 39 to 76 years, with an average of (60.14 ± 8.26) years. The main stages of esophageal cancer were stage Ⅲ 117 cases (48.15%) and stage Ⅳ 80 cases (32.92%). The level of vitamin A, B2, C and D in patients with esophageal cancer before initial treatment was lower than the normal value (P < 0.05). After 2 cycles of chemotherapy, the levels of vitamin A, B2, B6 and C decreased significantly (P < 0.05). After two cycles of chemotherapy, the levels of hemoglobin, total protein, serum albumin and blood calcium decreased，and the level of blood phosphorus increased significantly (P< 0.05). The changes of blood vitamin A (r=0.343，P<0.001) and C (r=0.388，P<0.001)were positively correlated with the changes of BMI. Conclusion There are vitamin A, B2, C and D deficiencies in patients with esophageal cancer receiving chemotherapy.
2022 Vol. 9 (1): 66-69 [Abstract] ( 300 ) HTML PDF (843 KB)  ( 216 )
70 Prognostic nutrition index as a predictive tool to evaluate the prognosis of pre‑treatment prostate cancer patients
Wang Xiaohong, Mei Guanghong
Objective To investigate the prognostic value of prognostic nutritional index (PNI) for prostate cancer patients. Method A total of 124 prostate cancer patients who were treated in Hai'an Hospital Affiliated to Nantong University from May 2016 to November 2019 were included in this study. All patients were divided into high PNI group (> 50.2, n = 62) and low PNI group (≤50.2, n = 62) based on the median value of PNI. The correlation between PNI and clinicopathological features of prostate cancer patients was analyzed, and Kaplan⁃Meier curves were plotted to evaluate the impact of pretreatment PNI on the overall survival of these patients. In addition, the Cox multivariate regression analysis was performed to determine the independent prognostic factors for prostate cancer patients. Result Low PNI was significantly correlated with TNM stage (P=0.031), but not with patient age, smoking history, prostate specific antigen (PSA) level, Gleason score and treatment methods. In this cohort, the median OS of prostate cancer patients was 43.0 months (range: 27.6-58.4). Kaplan⁃Meier survival curve showed that the OS of patients with low PNI was significantly shorter than that of those with high PNI. The 3⁃year OS of two patient groups was 50.9% and 79.9% respectively, with a significantly statistical difference(χ 2=10.967, P=0.001). Multivariate Cox regression analysis revealed that PNI before treatment(HR=3.174, 95%CI=1.122-8.978, P=0.029), Gleason score (HR=2.888, 95%CI=1.094-7.625, P=0.032) and TNM stage (HR=3.179, 95%CI=1.116-9.058, P=0.032) were independent prognostic factors for pretreatment prostate cancer patients. Conclusion PNI is an independent prognostic factor for pretreatment prostate cancer patients, and it might be used as an useful indicator of prognostic assessment.
2022 Vol. 9 (1): 70-73 [Abstract] ( 249 ) HTML PDF (876 KB)  ( 205 )
74 Effect evaluation of nutritional intervention based on case management in patients after radical gastrectomy for gastric cancer
Zhou Huali，Ma Hongli，Zhao Fazhi，He Weiyang，Gu Qiong，Bao Rong
Objective To explore the effect of nutritional intervention in case management on patients after radical gastrectomy for gastric cancer. Method Using real data studies, patients were divided into two groups according to the chronological order of surgery. In November 2017 to October 2018 as control group, 173 cases of patients with gastric cancer radical, control group patients during hospitalization, complete all screening, assessment, treatment, according to the situation of gastric bowel function, by the competent physicians, nurses, dietitians daily rounds to guide patients to eat, after hospital discharge, by the competent nurses for patients with gastric cancer surgery patients diet instruction manual, follow⁃up was completed at 1, 2, 3 and 6 months postoperatively. 166 patients in the experimental group underwent radical gastritis from November 2018 to October 2019. Patients in the experimental group received the same guidance during hospitalization, and were followed up by special case managers (including patients and their families) after discharge to understand the nutritional status of patients at home and give guidance. Nutritional risk, incidence of malnutrition, hemoglobin, serum total protein, prealbumin, albumin, weight gain, triceps dermal fold thickness, right hand grip strength and incidence of complications were compared between 2 groups. Result 166 patients completed the study. Without considering the effect of time accumulation on the results, nutrition intervention was implemented in case management. The nutritional risk and malnutrition incidence of the experimental group were lower than those of the control group at different periods of the investigation. Nutritional risk, good nutrition, hemoglobin, serum total protein, prealbumin, albumin, body weight gain and triceps skin fold thickness of the experimental group were significantly different from those of the control group (P < 0.05). Conclusion Nutritional intervention in case management of patients undergoing radical gastrectomy for gastric cancer is helpful to improve patients' wrong dietary concept and nutritional status.
2022 Vol. 9 (1): 74-79 [Abstract] ( 277 ) HTML PDF (875 KB)  ( 257 )
80 The clinical application value of nutrition education in patients with abdominal aortic aneurysm after radical resection
1 Pei Nannan,2 Liu Qianqian, 1 Yang Kun
Objective To investigate the application value of nutrition education in the radical operation of abdominal aortic aneurysm. Method 96 patients with radical surgery from Qingdao Municipal Hospital from October 2017 to October 2019 were selected, by control group (48 cases, routine care) and the observation group (48 cases, routine nursing combined nutrition education), comparing the rehabilitation effects, nutritional indicators and quality of life between the two groups, referring also to the anxiety self⁃assessment scale (SAS) and depression self⁃rating scale (SDS) determines the patient's psychological status. Result The first exhaust time, off⁃bed activity time and hospitalization time in the observation group were shorter than those in the control group. Mental state scores were lower than in the control group, the compliance and GQOLI⁃74 scores were higher than those in the controls. The difference was statistically significant (P<0.05), the weight of the observation group was (68.16±6.32) kg, the BMI was (23.02±0.54) kg/m2, the serum albumin level was (37.2± 2.4) g/L, and the serum transferrin level was (2.45±0.36) g /L, the serum prealbumin level is (267.27±25.12) mg/L, and the total iron binding capacity is (56.17±6.24) μmol/L, which are higher than the control group (64.32±5.44) kg and (21.72±0.78) kg /m2, (32.1±1.8)g/L, (2.16± 0.32) g/L, (215.12±22.26)mg/dl and (50.34±5.21) μmol/L, the difference was statistically significant (P<0.05). Conclusion The application of nutrition education in the radical operation of abdominal aortic aneurysm patients can promote patients' postoperative rehabilitation, relieve the negative emotions of patients, improve patient compliance, improve malnutrition, promote the improvement of quality of life.
2022 Vol. 9 (1): 80-83 [Abstract] ( 203 ) HTML PDF (838 KB)  ( 140 )
84 The value of MRI in the histological grading of endometrial cancer
Ren Jie, Jin Yanfang, Cui Tingting, Fu Zichao, Zhang Chao, Yue Yunlong
Objective To investigate the value of magnetic resonance imaging (MRI) in the histological grading of endometrial cancer. Method MR images of 64 patients with endometrial cancer confirmed by surgery from 2017 to 2020 were analyzed retrospectively from Beijing Shijitan Hospital Capital Medical University. The maximum left and right diameter, anterior and posterior diameter and head and foot diameter of tumor and uterus were measured on the maximum display level of the tumor and the median sagittal plane of the image respectively. According to the simplified ellipsoid volume formula, the volume of tumor and uterus was calculated and their ratio neoplasm/ uterus (N/U) was calculated, taking pathological findings as the gold standard, the differences of uterine volume, tumor volume and N/ U at different histological grades (G1, G2 and G3) were compared by Nonparametric test (Kruskal⁃Wallis test) and one⁃way ANOVA. According to the depth of tumor invasion and 5⁃year survival rate, G1, G2 and G3 tumors were divided into high⁃grade group and low⁃grade group. Receiver operating characteristic curve（ROC curve）was used to analyze the value of N/U in different group in predicting the histological grade of tumor before operation. Result Among the 64 cases of endometrial cancer, there were 20 cases of G1 grade, 24 cases of G2 grade and 20 cases of G3 grade. There was no significant difference in tumor volume among the three groups（H=3.528, P=0.171）. The N/U values of G1, G2 and G3 tumors were（0.13±0.07）,（0.19±0.06）,（0.21±0.08）, respectively. The difference among the three groups was statistically significant（F=9.04, P<0.01）. There was no statistically significant between high⁃grade group and low⁃grade group. Distinguishing G1 tumors from G2/G3 tumors with the cutoff value of 0.16, the area under curve (AUC) was 0.80, the sensitivity was 79.5% and the specificity was 80%. Conclusion MRI has certain diagnostic value for histological grading of endometrial cancer.
2022 Vol. 9 (1): 84-88 [Abstract] ( 190 ) HTML PDF (1137 KB)  ( 243 )
89 Investigation on the nutritional care status and influencing factors of caregivers of tumor chemotherapy patients
1,2 Zhou Qian, 2 Wang Yuanyuan, 2 Jiang Tingting, 1 He Zhangya, 2 Shao Min, 1 Luo Xiaoqin
Objective To understand the status of nutritional care for the caregivers of cancer patients undergoing chemotherapy and explore its influencing factors,so as to provide evidence for the hospital to formulate scientific and effective nutritional care plan for cancer patients. Method A total of 322 caregivers of chemotherapy patients were recruited in the Second Affiliated Hospital of Air Force Military Medical University from June to July 2021 using a stratified sampling method.A self⁃designed nutritional care questionnaire verified by reliability and validity was used for field questionnaire survey. Result The scores of nutritional care knowledge,trust and practice were(5.61±2.36),(23.98±2.99),(17.08±4.90),and the pass rates were 13.88%,99.37% and 53.31%,respectively.The knowledge, trust and practice of nutritional care in urban caregivers were higher than those in rural areas(β=1.526、1.002、1.585，P<0.01);The knowledge, trust and practice of nutritional care of those with college degree or above were higher than others(β=0.971,0.870,1.280,P<0.05);The caregiver behavior of married caregivers was relatively poor(β=⁃1.585,P<0.05);Nursing knowledge derived from the nutritional care behavior of medical staff was better(β=2.462,P<0.001);Caregivers whose knowledge was derived from electronic media had care knowledge (β=0.736,P<0.05)and behavior(β=1.180,P<0.05)were all better. Conclusion The caregivers of cancer chemotherapy patients were seriously lacking in nutritional care knowledge.They have a positive attitude towards nutrition care but their behaviors need to be improved. Nutritional care knowledge, belief and practice status are affected by their family location, education level, marital status and sources of nursing knowledge. Clinically,nutrition care programs for cancer chemotherapy patients should be formulated in accordance with the different characteristics of caregivers.Caregivers rural areas,under high school education,and the married should be the focus of attention, and health education should be carried out by means of medical personnel and electronic media education as far as possible.
2022 Vol. 9 (1): 89-94 [Abstract] ( 257 ) HTML PDF (856 KB)  ( 323 )
95 Role of perioperative period prognostic nutritional index for survival estimation in colorectal cancer patients
1 Wu Yongjin, 2 Xue Tianhui, 2 Yan Bing
Objective To explore the prognostic value of perioperative period prognostic nutritional index (PNI) (pre⁃/post⁃PNI) in predicting the 3 years progression free survival (PFS) and overall survival (OS) in colorectal cancer patients (CRC). Method A total of 153 pathologically confirmed colorectal adenocarcinoma underwent surgery were collected from December 2012 to January 2020 in Hainan hospital of Chinese PLA general hospital, the PNI were calculated and patients were then divided into different subgroups, the survival differences of these subgroups were run by Kaplan⁃Meier analysis and the risk factors for survival were tested by COX proportional hazards model. Result According to the Youden index, taking 48.73 and 45.40 as the cut⁃off points to divide patients into low or high pre⁃PNI and post⁃PNI subgroups respectively, they have a sensitivity at 71.40%, 83.70% and a specificity at 59.60%, 46.20% individually in predicting the survival. The lower pre⁃PNI was more obvious in T3+T4 (P=0.02), M1 (P=0.02) patients; whereas the lower post⁃PNI was more apparent in older ones (P=0.03), both of which were more detectable in big tumor groups (all P=0.04). Both PFS and OS were inferior in lower pre⁃PNI and post⁃PNI ones (all P<0.01). The preoperative period PNIs were risk factor for PFS and OS; however, only the post⁃PNI was of more reliable (PFS: HR=0.31, 95%CI= 0.14-0.69, P<0.01; OS: HR=0.26, 95%CI=0.10-0.69, P=0.01). Conclusion The perioperative period PNI played an important role in predicating the survival for colorectal cancer patients. However, the post⁃PNI was more reliable when compared with the pre⁃PNI, additional studies are still needed in future.
2022 Vol. 9 (1): 95-100 [Abstract] ( 212 ) HTML PDF (1071 KB)  ( 241 )
101 The predictive value of controlled nutritional status score in postoperative recurrence and metastasis of breast cancer patients
1 Ye Jian, 1 Zhang Jing, 2 Ji Liping, 3 Chen Lijuan
Objective To investigate the predictive value of controlled nutritional status (CONUT) for tumor recurrence and metastasis of breast cancer patients. Method The clinicopathological features and survival follow⁃up data of 168 breast cancer patients who underwent surgical resection in Rugao People􀆳s hospital from April 2013 to August 2019 were retrospectively collected. CONUT score was calculated based on the lymphocyte count in the peripheral blood, preoperative serum albumin and total cholesterol levels. All patients were divided into high CONUT (≥3 points) and low CONUT (<3 points) based on the preoperative CONUT score. Chi square test was used to evaluate the relationship between CONUT score and clinicopathological features of breast cancer patients. Kaplan⁃Meier curves were plotted, and the univariate and multivariate Cox regression analysis were conducted to investigate the prognostic value of CONUT score for breast cancer patients. Result High CONUT (≥3 points) was significantly associated with advanced T stage (χ２= 6.666, P=0.036) and lymph node metastasis(χ２ = 4.562, P=0.033). Kaplan⁃Meier curves showed that breast cancer patients with CONUT ≥3 had a higher risk of recurrence and metastasis than those with CONUT <3, and the 5⁃year recurrence⁃free survival (RFS) of the two groups was 78.6% and 96.0%, respectively (χ２=11.562, P=0.001). Subgroup analysis further demonstrated that CONUT ≥3 was markedly correlated to poor RFS of breast cancer patients, regardless of TNM Ⅰ-Ⅱ (5⁃year RFS: 82.6% vs 96.3%; χ２= 4.424, P=0.035) and stage Ⅲ (5⁃year RFS: 40.9% vs 89.1%; χ２= 9.103, P=0.003). The results of univariate and multivariate analysis revealed that T stage (HR=3.875, 95%CI=1.080-13.903, P=0.038), lymph node metastasis (HR=3.354, 95%CI=1.166-9.645, P=0.025) and CONUT (HR=3.003, 95%CI=1.168-7.720, P=0.022) were independent predictors of recurrence and metastasis in breast cancer patients. Conclusion CONUT could be used as an useful predictor of recurrence and metastasis in breast cancer patients.
2022 Vol. 9 (1): 101-105 [Abstract] ( 241 ) HTML PDF (1174 KB)  ( 388 )
106 Research progress of vitamin D on prevention and treatment of pancreatic cancer
1 Zhang Pan, 2 Shang Cui, 3 Xu Yun
Pancreatic cancer is a malignant tumor with high mortality, characterized by early metastasis, late diagnosis, and therapeutic resistance, the radical resection rate is low and the prognosis is poor. At present, the first⁃line combined chemotherapy regimen for pancreatic cancer is unsatisfactory, and the survival rates remain low, there is no cure or effective treatment for pancreatic cancer. Therefore, it is urgent to develop effective intervention strategies. Studies have shown that vitamin D has a positive preventive and therapeutic effect on the occurrence and development of various malignant tumors, vitamin D as a new target for prevention and treatment of pancreatic cancer, has become one of the research hotspots in recent years. At present, the results show that vitamin D and its analogues play positive roles in the treatment of pancreatic cancer, which can improve the prognosis and reduce the mortality. To data, there is no sufficient evidence to support, high quality clinical studies are needed to explore vitamin D supplementation, intervention time and combination therapy, providing sufficient evidence for the treatment and prevention of pancreatic cancer. In this article, we reviewed the effects of vitamin D on the incidence and mortality of pancreatic cancer, while discussed the possible mechanisms. The latest research progress of vitamin D and its analogues combined with chemotherapy/immunotherapy for pancreatic cancer were summarized. Taken together, vitamin D and its analogues are cost⁃effective drugs, which have important value and broad application prospects for the prevention and treatment of pancreatic cancer.
2022 Vol. 9 (1): 106-111 [Abstract] ( 542 ) HTML PDF (661 KB)  ( 295 )
112 Advances in the study of cytoglobin in inhibiting the transformation of non‑alcoholic steatohepatitis into hepatic cell carcinoma
1Bai Yu，1Huang Feng，2,3Chao Xu
Cytoglobin（GYGB）, a stellate cell⁃specific globin, has recently become a hotspot protein due to its association with liver fibrosis. The control of inflammation in tumor occurrence and development plays a quite important role in the process, and the transformation of“inflammation⁃cancer”mechanism research in the field of cancer basic research has become a new frontier, and the transformation of“inflammation⁃cancer”regulation network, molecular mechanism and signal pathway has gradually become the main target of tumor prevention and treatment. This review mainly summarizes the potential functions of globulin in the liver, including oxidative stress and signaling pathway transduction, and further discusses the inhibition of CYGB in the transformation from non⁃alcoholic steatohepatitis to primary liver cancer in three aspects: inactivation of hepatic stellate cells, increase of fat transport and resistance to oxidative stress. The study of“inflammation⁃cancer”transformation will provide a new breakthrough for the prevention, diagnosis and treatment of primary liver cancer.
2022 Vol. 9 (1): 112-116 [Abstract] ( 277 ) HTML PDF (1047 KB)  ( 289 )
117 Metabonomics and its application in tumor research
1 Zhang Nan, 2 Kong Dan, 1 Yang Shujia, 1 Jin Xiaoming
Metabolomics is an emerging "omics" after genomics, proteomics and transcriptomics, which is often used in disease diagnosis, medical research and development, nutrition and food science, toxicology, environmental science, botany and other fields closely related to human health. Since the 20th century, the number of articles on metabonomics published every year has been increasing. In particular, the research of metabonomics in tumor is also increasing. On the surface, metabonomics is developing rapidly, but it still lags far behind genomics and proteomics. The emergence of metabonomics is the necessity of life science research. Metabonomics is a new subject for qualitative and quantitative analysis of small molecular metabolites in a certain organism or cell. Tumor is a common disease that seriously endangers human health and life, and all tumors are characterized by changes in cell metabolism. Therefore, metabolomics shows great potential in the screening of tumor metabolic markers, the evaluation of prognosis, and the design of drug targets.At present, metabonomics has been widely used in the study of various tumors, and with the continuous progress of metabonomics analysis platform, bioinformatics technology and the establishment of database, it will play a very important role in the clinical diagnosis and treatment of tumors. In this review, metabolomics and its research progress in tumor are reviewed.
2022 Vol. 9 (1): 117-121 [Abstract] ( 380 ) HTML PDF (1071 KB)  ( 447 )
122 Research progress on the relationship between lipid metabolism and the development of colorectal cancer
Chen Yi, Li Jianguo, Wang Jiwei
Lipids include fats (triglycerides) and lipids (phospholipids and sterols). Lipids provide essential fatty acids and energy for the body. Lipid metabolism disorder is considered to be the metabolic feature of many malignant tumors, including colorectal cancer. Abnormal lipid metabolism will lead to changes in cell membrane structure, abnormal cell signal transduction, imbalance of energy homeostasis, destruction of gene expression and protein distribution, which will affect a series of cell functions such as cell proliferation, differentiation, metabolism, apoptosis and information transmission. Studies have shown that abnormal lipid metabolism is closely related to the occurrence and development of colorectal cancer. High level of fatty acid metabolism is one of the most abnormal metabolic changes of tumor cells. Some lipid metabolic pathways may become potential specific targets for the treatment of colorectal cancer. The relationship between lipid metabolism and the occurrence and development of colorectal cancer, as well as their interaction, is one of the hot spots of tumor nutrition and metabolism. At present, the research results are still controversial and need to be further confirmed by more clinical and basic studies. This paper will systematically elaborate the relationship between lipid metabolism and the occurrence and development of colorectal cancer from three aspects of fatty acid, triglyceride and cholesterol, and inspire the cellular signal and molecular mechanism of interfering with its metabolic pathway, which may provide a new direction for the treatment of colorectal cancer.
2022 Vol. 9 (1): 122-127 [Abstract] ( 798 ) HTML PDF (1936 KB)  ( 507 )
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