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2022 Vol. 9, No. 2
Published: 2022-04-09
 
129 Improving sleep of hospitalized patients is of high priority
1Tian Hongmei, 2,3Yu Kaiying, 2,3,4Shi Hanping
Poor sleep in hospitalized patients is a significant problem that has been ignored for a long time, mainly manifested as shortened sleep duration and decreased sleep quality. There are many factors that affect the sleep of patients, primarily noise, nursing care, and lighting. Pain is the main factor that affects the sleep of patients after surgery. In most cases, poor sleep in hospitalized patients can be prevented and treated. In order to solve the problem of poor sleep in hospitalized patients, it will need multiple measures which include improving the awareness of sleep problems, strengthening sleep diagnosis, routine evaluation of sleep, creating a good sleep environment, reducing the median sound level in hospital, optimizing ward nursing management, reducing the interference of nursing care on sleep and increasing necessary non⁃drug and drug intervention. Poor sleep in hospitalized patients is related to medical quality and patient safety, which needs the attention of the whole society, health management leaders, hospital management departments, and especially the whole medical care team.
2022 Vol. 9 (2): 129-133 [Abstract] ( 222 ) HTML PDF (945 KB)  ( 325 )
134 Recent advances in biomarkers of sarcopenia
1,2Du Hongzhen, 3Sun Kejuan, 1,2Li Zengning
Sarcopenia is a progressive and widespread decline in skeletal muscle mass and strength, as well as the resulting decline in physical fitness, quality of life, and death. There are two types of sarcopenia, primary and secondary sarcopenia. Sarcopenia is closely related to dysactivity, falls, low bone density and metabolic disorders. It has a high incidence and a wide range of adverse results. The quality of life of patients with sarcopenia decreases, which brings a heavy economic burden to individuals and families, and even serious adverse effects on social public health. However, sarcopenia is often underdiagnosed in clinical practice. In recent years, based on the research on the pathogenesis of sarcopenia, a variety of potential biomarkers have been proposed, such as myostatin, circulating C⁃terminal aggregate protein fragments and type Ⅲ procollagen N⁃terminal peptides, etc., which are usually related to specific pathogenic mechanisms and/or phenotypes. Effective biomarkers can promote the early diagnosis and prognosis of sarcopenia, and analyze the severity of the disease, and the effect of treatment is evaluated, but there is currently no effective biomarker standard. This article focuses on the recent advances in biomarkers of sarcopenia that have received high attention at home and abroad, and provide a reference for the improvement of patients with sarcopenia. It will provide a theoretical basis to help many clinicians reasonably evaluate the patient's sarcopenia status and take appropriate intervention measures to solve the troubles.
2022 Vol. 9 (2): 134-140 [Abstract] ( 402 ) HTML PDF (1073 KB)  ( 441 )
141 Application of mass spectrometry in nutritional diagnosis and treatment of tumor
Zhou Chuangui, Li Yan, Cheng Wenbo
Tumor nutrition is a new discipline that applies nutrition methods and theories to prevent and treat tumors. Malignant tumor patients are at high risk of malnutrition. Malnutrition will affect the treatment, prognosis and survival time of tumor patients. Therefore, a dual diagnosis of tumor and nutrition is required for tumor patients when they are admitted to hospital. As a highly sensitive and highly specific detection method, mass spectrometry can be used for accurate monitoring of various indicators in the human body, and provide accurate and rich diagnosis and treatment information for tumor patients from the perspective of nutrition. In this paper, the application of mass spectrometry technology in tumor nutrition diagnosis and treatment was reviewed. The applications of liquid chromatography⁃triple quadrupole mass spectrometry, time⁃of⁃flight mass spectrometry, and inductively coupled plasma mass spectrometry in tumor nutrition diagnosis and treatment were summarized. This paper reviewed the accurate detection of vitamins, trace elements, glucocorticoids, therapeutic drugs and other indicators in the human body by mass spectrometry. More accurate data support will be provided to nutritional support for clinical tumor patients.
2022 Vol. 9 (2): 141-147 [Abstract] ( 306 ) HTML PDF (2037 KB)  ( 341 )
148 A systematic review on muscle mass evaluation of GLIM criteria
1Ruan Xiaoli, 2,3,4Shi Hanping, 1Liu Fen
Malnutrition is a subacute or chronic nutritional state, which can lead to changes in body composition and impaired functions, has an effect on treatment and clinical outcomes. Early and accurate identification of patients who are malnourished or at nutritional risk is essential to improve nutritional status and prognosis. However, there is a lack of clear and uniform definitions and diagnostic criteria for malnutrition, and the consensus on diagnostic criteria for malnutrition issued by the European Society for Parenteral and Enteral Nutrition in 2015 has not been widely recognized. In 2018, the Global Leadership Initiative on Malnutrition (GLIM) consensus aims to unify the diagnostic criteria for malnutrition in adult hospitalized patients. Since the GLIM consensus has not yet proposed a unified method for muscle mass, which leads to different methods used to assess muscle mass between studies. The selection of effective assessment indicators and tools can accurately and timely assess the muscle mass, and provide a reference for nutritional status assessment. The paper reviews the assessment indicators and tools for muscle mass in the researches related to the GLIM criteria, aiming to get general overview of relevant researches on nutritional assessment using GLIM criteria in clinical practice, the indicators involved and related thresholds, provide reference for accurate and effective assessment of muscle mass in clinical practice and perfecting the application of GLIM criteria.
2022 Vol. 9 (2): 148-159 [Abstract] ( 437 ) HTML PDF (1807 KB)  ( 426 )
160 Research progress of microbiome technology in tumor diagnosis
1Li Sheng, 2Duan Yunfeng, 1Zhao Jun
Humans are exposed to a wide range of microorganisms at birth, including bacteria, viruses, fungi, archaea, protozoa, and helminths. Preclinical and clinical evidence has linked the microbiota and its metabolites to tumor initiation, promotion, and progression. The conventional concept is that organismal microbial homeostasis is positively correlated with health, while microbial diversity or dysfunction promotes the development of diseases, including various types of cancer. Causes of dysbacteriosis include changes in genetics, environment (e.g., inflammation, drugs, diet), or pathogenic infections. However, it remains controversial whether microbial imbalance is a cause or a consequence of tumor development. Therefore, the interrogation of the role of microorganisms in tumors requires a holistic perspective. In this review, we describe the composition of cancer microbiome, progress methods of microbial detection and their role in cancer diagnosis, and provide an outlook on future research on cancer microbiome.
2022 Vol. 9 (2): 160-167 [Abstract] ( 282 ) HTML PDF (943 KB)  ( 645 )
168 Research progress of hypermetabolism and its mechanism in tumor patients
Miao Mingyong
The incidence of moderate to severe malnutrition in malignant tumors is very high. The latest research shows that the incidence of moderate to severe malnutrition in Chinese tumor patients is 58%. Malnutrition significantly affects the clinical outcome of tumor patients, and nearly 25% of tumor patients die directly from malnutrition. Many malnourished tumor patients often show high resting energy expenditure and hypermetabolism. The factors causing these changes mainly include two aspects: ① tumor load; ② the related factors caused by tumor, including inflammation, neuroendocrine disorder, radiotherapy and chemotherapy, intestinal microecological disorder, loss of appetite and intake, etc. These factors are mixed together and activate the increased energy consumption of different tissue and organ systems, enhanced catabolism and decreased anabolism through complex mechanisms that are not fully clarified, resulting in malnutrition in tumor patients. Because the factors and mechanisms causing malnutrition (including cachexia) in tumor patients are complex and diverse, it is necessary to comprehensively evaluate and diagnose malnutrition in tumor patients first, and then carry out effective comprehensive nutritional intervention and drug intervention to
2022 Vol. 9 (2): 168-174 [Abstract] ( 376 ) HTML PDF (1067 KB)  ( 499 )
175 Standards of standardized surgical nutritional diagnosis and treatment ward
The incidence of malnutrition in surgical patients is high. Perioperative fasting and water restriction, invasive operation, surgical strike, long⁃term bed rest and other factors will lead to increased catabolism, intensified inflammatory response, imbalance of protein homeostasis, thus aggravate malnutrition. Malnutrition not only affects the clinical decision of surgical treatment, but also increases the incidence of complications and mortality, reduces the quality of life, and affects the clinical outcomes. Reasonable, effective, and standard surgical nutritional therapy can improve the energy balance, increase physiological reserve, and speed up postoperative recovery. Surgeons' understanding of nutritional therapy is not sufficient nowadays, and there exists the phenomenon of underapplication and overapplication. Therefore, it is particularly important to establish the standard of surgical nutritional therapy. This standard aims to establish a standardized management system of surgical nutrition, promote the rational application of surgical nutrition therapy, which is of great significance in preventing and treating malnutrition, maintaining medical safety of patients, improving the quality of life of patients, and saving medical costs. It is hoped that this standard can provide theoretical guidance for surgical nutrition treatment and contribute to the improvement of clinical nutrition and the acceleration of the development of enhanced recovery after surgery in China.
2022 Vol. 9 (2): 175-184 [Abstract] ( 364 ) HTML PDF (1324 KB)  ( 183 )
185 Expert consensus on nutritional treatment for patients with hematological tumor
Malnutrition is common in the diagnosis and treatment of patients with hematological tumor. Chemotherapy, as the most important treatment of hematological tumor, aggravates the malnutrition of patients further. The main reason is the nausea, vomiting and reduced food intake caused by chemotherapy. The significant increase of C⁃reactive protein after induction treatment indicates that the incidence of infection and the level of inflammation are high, which may interfere with the body's metabolism and aggravate the deterioration of nutritional status to a certain extent. Malnutrition in patients with hematological tumor is characterized by abnormal body mass index, abnormal body composition, abnormal overall/comprehensive evaluation and abnormal biochemical indexes. The principle of nutritional treatment for patients with hematological tumor is similar to that of other tumor, with enteral nutrition as the main and parenteral nutrition as the supplement. However, special nutrients should be supplemented: ①glutamine; ②diet for "granulocytopenia"; ③ω⁃3 polyunsaturated fatty acids; ④ bovine colostrum and soybean diet. Through nutritional screening and evaluation, formulating nutritional treatment plans for patients with hematological tumor at different treatment stages and timely and appropriate individualized nutritional treatment can significantly improve the nutritional status of patients with hematological tumor, prevent malnutrition and
2022 Vol. 9 (2): 185-189 [Abstract] ( 389 ) HTML PDF (888 KB)  ( 401 )
190 Application of nutritional management during postoperative chemotherapy in children with high‑risk neuroblastoma
1Zhao Wenli, 2Ma Xiaoli, 1Yang Wenli, 1Xia Lulu, 1Yan Jie
Objective To investigate the effect of nutritional management during postoperative chemotherapy in children with neuroblastoma. Method A total of 88 neuroblastoma patients treated in Hematology Oncology Center, Beijing Children’s Hospital, Capital Medical University from November 2019 to March 2021 after chemotherapy were randomly divided into control group and observation group, 44 patients each. The control group received routine diet nursing, and the observation group received whole⁃course nutrition management on the basis of routine nursing. Centralized management in the hospital and Wechat group management established outside the hospital lasted for 3 months. Nutritional indicators and adverse reactions of patients in the two groups during postoperative chemotherapy were compared. Result The absolute values of serum prealbumin [ (169.66±30.46) mg/L vs (158.68±19.18) mg/L], serum albumin [(44.86±3.72) mg/L vs (42.90±4.47) mg/L], hemoglobin [(108.23±14.16) g/L vs (102.36±11.37) mg/L] and lymphocytes [0.91 (0.64, 1.11)×109 vs 0.68 (0.42, 1.02)×109] in the observation group were higher than those in the control group (P<0.05); the weight gain was higher than that of the control group, but there was no significant difference (P=0.238). The incidence of adverse reactions, such as malnutrition risk screening score [(5.23±1.51）vs（6.05±1.90）], infection [10 (22.7%) vs 19 (43.2%)], anorexia [15 (34.1%) vs 29 (65.9%)] and reduced chemotherapy intensity [1 (2.3%) vs 6 (13.6%)] were lower in the observation group than in the control group. The difference was statistically significant (P<0.05). The incidence of malnutrition and diarrhea was lower than that of control group (P>0.05). Conclusion Nutritional management can effectively improve the nutritional status of patients after tumor operation and reduce the incidence of malnutrition and adverse reactions of chemotherapy.
2022 Vol. 9 (2): 190-194 [Abstract] ( 210 ) HTML PDF (928 KB)  ( 268 )
195 Analysis of nutritional status and influencing factors of hospitalized patients with common cancer
1Weng Min, 1Dai Zhengyan, 1Gan Zhiming, 1Yang Liuqing, 2,3Shi Hanping, 4Wang Kunhua
Objective To investigate the nutritional status of hospitalized patients with common cancer and influencing factors. Method From January 2018 to December 2019, we enrolled 1385 patients with cancer hospitalized for treatment in First Affiliated Hospital of Kunming Medical University. These patients were diagnosed with malignant tumors by pathologically. Demographic data, anthropometric measurements and laboratory examination within 48 hours of admission were collected, patient⁃generated subjective global assessment (PG⁃SGA) was used to evaluate the nutritional status and influencing factors of nutritional status were analyzed. Result There are 980 males (70.8%) and 405 females (29.2%), and average age of (56.5±13.4) years in our 1385 cases. The average PG⁃SGA score was (6.92±5.27), with PG⁃SGA score as standard, 203 patients (14.7%) had the good nutrition, 279 patients (20.1%) were mild malnutrition, 429 patients (31.0%) were moderate malnutrition, 474 patients (34.2%) were severe malnutrition. 23.0% (319/ 1385) of patients received enteral nutritional therapy, 36.6% (507/1385) received parenteral nutritional therapy, 7.1% (99/1385) received enteral and parenteral nutritional therapy. After controlling for confounding factors, Logistic regression analysis demonstrates that age (≥70 years old), male, tumor metastasis, weight loss in the recent 1-3 months and diet loss in the recent 1 week were risk factors for malnutrition. Higher serum albumin, hemoglobin and hand grip strength were protective factors for malnutrition, the differences were statistically significant (P<0.05). Conclusion With PG⁃SGA score as standard, 85.3% of the cancer patients were malnutrition and 65.2% of them were moderate/severe malnutrition, and there was a low rate of nutritional treatment. Patients with age (≥70 years old), male, tumor metastasis, weight loss in the recent 1⁃3 months and diet loss in the recent 1 week are likely to have malnutrition. Patients with higher serum albumin, hemoglobin and hand grip strength have less malnutrition.
2022 Vol. 9 (2): 195-199 [Abstract] ( 282 ) HTML PDF (913 KB)  ( 387 )
200 Construction and analysis of adverse reaction prediction model for liver cancer patients with radiotherapy and chemotherapy containing nutritional indicators
Ma Dongbo, Wang Zhong
Objective To explore the construction of a predictive model for adverse reactions of liver cancer patients with radiotherapy and chemotherapy containing nutritional indicators. Method Prospectively selected 231 patients with liver cancer radiotherapy and chemotherapy admitted to Lianyungang First People's Hospital from January 2019 to March 2021 as the research objects. Randomly selected 70% (162 cases) of cases as the modeling set, and 30% (69 cases) as the test set. Compared the relevant data of the modeling set after radiotherapy and chemotherapy, and apply multi⁃factor Logistic regression to screen the relevant factors, construct the prediction model, use the consistency index (C⁃index) to quantify and calibrate the curve, evaluate the performance of the model, draw the decision curve to analyze and evaluate the clinical net of the nutritional index model. At the same time, external verification of the model is performed on the test set. Result After one course of radiotherapy and chemotherapy, 74 cases (45.68%) in the modeling set had adverse reactions and were classified as the adverse reaction group, and 88 cases (54.32%) without adverse reactions were classified as the non⁃adverse reaction group. In modeling set two groups, tumor diameter, controlling nutritional status (CONUT) score, alpha⁃fetoprotein (AFP), alkaline phosphatase (ALP), γ⁃glutamyl transferase (GGT), des⁃γ⁃carboxy prothrombin (DCP), and prognostic nutritional index (PNI) had statistically significant differences (P<0.05). Multivariate Logistic analysis showed that tumor diameter (OR=1.699, 95%CI=1.117-2.583), CONUT score (OR=2.396, 95%CI=1.205-4.763), AFP (OR=1.068, 95%CI=1.020-1.118), DCP (OR=1.013, 95%CI=1.000-1.025), GGT (OR=1.090, 95%CI=1.037-1.144), ALP (OR=1.013, 95%CI=1.003-1.023) in liver cancer are independent risk factors for adverse reactions and chemotherapy. PNI (OR=0.913, 95%CI=0.875-0.953) is a protective factor for adverse reactions (all P<0.05). The Nomogram model predicts the occurrence of adverse reactions with a C⁃index of 0.867 (95%CI=0.815-0.920). The decision curve shows that when the predicted value of the model with CONUT score and PNI nutrition⁃related index is in the interval (0-0.6), additional clinical benefits can be provided. External validation showed that among the 69 patients in the validation set, 31 (44.93%) had adverse reactions and were classified as the adverse reaction group, and 38 (55.07%) without adverse reactions were classified as the non⁃adverse reaction group. The prediction sensitivity of the model was 90.32% and the specificity was 91.67%. Conclusion The prediction model constructed with CONUT score and PNI nutritional indicators can improve the accuracy of predicting the occurrence of adverse reactions in patients with liver cancer radiotherapy and chemotherapy.
2022 Vol. 9 (2): 200-206 [Abstract] ( 236 ) HTML PDF (1112 KB)  ( 659 )
207 Effect of postpyloric enteral nutrition in patients with cervical spinal cord injury undergoing mechanical ventilation
Zhou Jian, Zhou Qiuxiang, Yan Yueyue, Qu Jinlong
Objective To explore the effect of postpyloric enteral nutrition (EN) in patients with cervical spinal cord injury undergoing mechanical ventilation (MV). Method 70 patients with cervical spinal cord injury who were treated with MV in intensive care unit (ICU) of Second Affiliated Hospital of PLA Naval Medical University from September 2018 to September 2020 were randomly divided into two groups, nasointestinal tube group and nasogastric tube group. Among them, 4 cases in the control group withdrew from the experiment for some reason and the final two groups with 35 and 31 cases respectively. Blood urea nitrogen (BUN), hemoglobin (HB), serum albumin (ALB), prealbumin (PA) before treatment, 3 days, 7 days after treatment and before discharge, duration of MV, ICU hospitalization time and the incidence of reflux and abdominal distension were observed and compared. Result The PA level in nasointestinal tube group was significantly higher than that in nasogastric tube group before discharge [(339.2±105.7) mg/L vs (286.5 ± 86.5) mg/L] (P<0.05), the other nutritional indexes had no significant difference (P>0.05). Compared with nasogastric tube group, patients in nasointestinal tube group had shorter ventilator support time [3.0(2.0,8.0) d vs 6.0(3.0,11.0) d], lower incidence of abdominal distension[14.3% (5/35) vs 35.5% (11/ 31)], lower hospitalization time[9.0(8.0,12.0) d vs 12.0(9.0,15.5) d], and the differences were significant (P<0.05). Conclusion EN with nasointestinal tube can improve the nutritional status of patients with cervical spinal cord injury, shorten the duration of MV and ICU hospitalization time, and reduce the incidence of gastrointestinal complications.
2022 Vol. 9 (2): 207-211 [Abstract] ( 217 ) HTML PDF (979 KB)  ( 182 )
212 Effects of lycium barbarum polysaccharide on intestinal microbiota regulation in ulcerative colitis mice
Li Zhiyu, Lin Lanhui, Hao Qiyuan, Zhai Huihong
Objective To investigate the protective effect of lycium barbarum polysaccharide (LBP) on ulcerative colitis and its regulatory effect on the intestinal flora. Method 20 specific⁃pathogen free (SPF) and 20 germ⁃free (GF) C57BL/6 healthy male mice were respectively divided into dextran sulphate sodium (DSS) group (n=10, SPF), LBP group (n=10, SPF), GF (DSS) group (n=10) and GF (LBP) group (n=10). The model of ulcerative colitis was established by discontinuously drinking 2% DSS for 7 days with three cycles, totally for 54 days. DSS and GF (DSS) groups were given a normal diet, while LBP and GF (LBP) groups were given 1% LBP dietary supplement throughout the whole process. Finally, the UC phenotype (body weight, colon length, disease index score and myeloperoxidase activity) were assessed in each group. And the feces of mice were collected by stress defecation method, and the composition of intestinal flora was analyzed by 16S rRNA high⁃throughput sequencing. The content of short⁃chain fatty acids in feces was detected by gas chromatography⁃mass spectrometry. Result LBP exerted a significant effect against UC, as indicated by increased body weight and colon length, and decreased disease activity index scores and myeloperoxidase activity. But the protective effect of LBP on UC was reversed in GF mice. The abundance of some probiotics, such as Lactobacillus [(0.55±0.38)×10⁃2 vs (3.83±1.78)×10⁃2, P=0.009], unclassified Lachnospiraceae [(1.84±0.42)×10⁃2 vs (3.90±1.36)×10⁃2, P=0.023], Butyricicoccus [(0.03±0.04)×10⁃2 vs (0.11±0.01)×10⁃2, P=0.007], unclassified S24⁃7 [(9.91±1.44) ×10⁃2 vs (28.90±15.68) ×10⁃2, P=0.004], increased obviously with LBP treatment. In addition, LBP significantly increased the content of butyric acid in the feces of mice with UC [(3.96±0.78) ng/mg vs (7.44±1.67) ng/mg, P=0.022]. However, LBP did not increase the content of butyric acid in GF mice [(6.02±0.13) ng/mg vs (6.05±0.11) ng/mg, P=0.150]. Conclusion LBP can alleviate DSS⁃induced UC by regulating the composition of intestinal flora and promoting the production of butyric acid.
2022 Vol. 9 (2): 212-218 [Abstract] ( 294 ) HTML PDF (1464 KB)  ( 427 )
219 The effect of individualized nutrition with dietary energy on postoperative radiotherapy patients with thyroid cancer
1Zhou Yingjun, 1Yin Hongtao, 1Cai Lili, 2Zhou Yanqing, 3Wu Di
Objective To explore the effect of individualized nutritional intervention based on dietary energy on the radiotherapy tolerance, nutritional status and quality of life of patients with postoperative radiotherapy for thyroid cancer. Method 98 patients with postoperative radiotherapy for thyroid cancer treated in Qinhuangdao First Hospital from January 2018 to June 2020 were selected as the research objects. According to the filing order of admission, patients were divided into control group and observation group, 49 patients each. From radiotherapy, the control group was given routine nutrition intervention, and the observation group was given individualized nutrition intervention based on dietary energy supply for 4 weeks. The body mass, upper arm muscle circumference and skinfold thickness, radiation tolerance, nutritional status [serum albumin (SA), prealbumin (PA), transferrin (TF)] before and after intervention, cancer⁃related fatigue, quality of life (FLIC) and nutritional diet compliance were compared between the two groups. Result After the intervention, the body weight, upper arm muscle circumference and skinfold thickness of the observation group were higher than those of the control group (P<0.05); after the intervention, the observation group had PA (350.47±52.32) mg/L, SA (35.48±2.01) g/L, TF (2.26±0.54) g/L are higher than the control group (321.48±42.32) mg/L, (31.12±2.86) g/L, (1.90±0.50) g/L (P<0.05); the radiotherapy tolerance of the observation group was higher than that of the control group (P<0.05); the degree of cancer⁃related fatigue in the observation group (no fatigue or mild fatigue 48.98%, moderate fatigue 30.61%, severe fatigue 20.41%) was low In the control group (26.53%, 36.73%, 36.73%) (P<0.05); the FLIC score of the observation group after intervention was higher than that of the control group (P<0.05); the nutrition diet compliance of the observation group was higher than that of the control group (P<0.05). Conclusion Individualized nutritional intervention based on dietary energy can help improve the nutritional status of patients undergoing radiotherapy for thyroid cancer, maintain their body mass, reduce cancer⁃related fatigue, enhance radiotherapy tolerance, and improve the quality of life.
2022 Vol. 9 (2): 219-223 [Abstract] ( 183 ) HTML PDF (911 KB)  ( 252 )
224 Construction of a nomogram model of malnutrition risk in patients undergoing chemotherapy after breast cancer surgery
Zhang Jing, Xia Yan, Wang Zhaojin, Jing Li, Lu Xiaoyun, Lin Zhijuan
Objective To analyze the influencing factors of malnutrition risk in breast cancer patients undergoing chemotherapy and construct a nomogram model based on the analysis results. Method The relevant data of 231 breast cancer patients undergoing chemotherapy in Affiliated Hospital of Yangzhou University were retrospectively analyzed, taking body mass index (BMI) <18.5 kg/m2 and nutritional risk screening 2002 (NRS 2002) score≥3 points as the criteria for judging malnutrition, they are divided into malnutrition group (65 cases) and normal nutrition group (166 cases). The multivariate Logistic regression were used to analyze the influencing factors of malnutrition risk in breast cancer patients undergoing chemotherapy, and a nomogram prediction model was constructed based on the analysis results, then use the area under the receiver operating characteristic (ROC) curve and the H⁃L fit curve to evaluate the effectiveness and discrimination of the model. Use the decision curve analysis (DCA) to evaluate the predictive value of the model. Result 65 patients in this study developed malnutrition, accounting for 28.14%. There were significant differences in age, adjuvant radiotherapy, liver damage, relative dose intensity of chemotherapy drugs, oral mucositis, gastrointestinal reactions (constipation and abdominal distension) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age ≥60 years old, adjuvant radiotherapy, relative dose intensity of chemotherapeutics of 85%-100%, and gastrointestinal reactions were independent risk factors for malnutrition in patients undergoing chemotherapy after breast cancer surgery (P<0.05). According to the results of multivariate Logistic regression analysis, a nomogram prediction model for malnutrition in patients undergoing chemotherapy after breast cancer surgery was constructed and evaluated, the area under the ROC curve was 0.824, the sensitivity was 73.8%, and the specificity was 96.0%. The H⁃L fit curve results showed that χ2=7.241, P=0.412. Conclusion Age≥60 years old, adjuvant radiotherapy, the relative dose intensity of chemotherapy drugs of 85%-100% and gastrointestinal reactions were independent risk factors for malnutrition in patients undergoing chemotherapy after breast cancer surgery. The constructed nomogram prediction model has good predictive value, and can be used as a tool to screen the risk of malnutrition in patients undergoing chemotherapy after breast cancer surgery
2022 Vol. 9 (2): 224-228 [Abstract] ( 312 ) HTML PDF (1033 KB)  ( 376 )
229 Effect of HMB on cancer‑related fatigue and quality of life in elderly surgical patients with stageⅠ-Ⅲ colon cancer
1Yang Liuqing, 2Wang Lin, 3Tian Hongmei, 4Wang Kunhua, 5Liu Ming, 6Yu Zhen, 1,2,7Shi Hanping
Objective To study the effects of adding β⁃hydroxy⁃β⁃methylbutyrate (HMB) to oral nutritional supplements on elderly patients with stage Ⅰ-Ⅲ colon cancer to improve postoperative fatigue and quality of life. Method Colon cancer patients enrolled from January 2020 to June 2021 in Beijing Shijitan Hospital, First Affiliated Hospital of Kunming Medical University, Fourth Affiliated Hospital of Harbin Medical University, and Tenth People's Hospital Affiliated to Tongji University were hospitalized for radical resection. Divided into HMB intervention group and control group, by using the brief fatigue inventory (BFI) and the quality of life questionnaire⁃core 30 (QLQ⁃C30) scale to assess the degree of fatigue and quality of life of patients before and after surgery. Timed take⁃off test was used to assess the patient's overall physical fitness, white blood cell count and C⁃reactive protein to assess the changes in the patient's inflammation level. The patient's total hospital stay and total hospital expenses were recorded. Result The postoperative fatigue of the HMB intervention group was better than that of the control group in all dimensions (P<0.05). The overall quality of life of patients in the HMB intervention group was better than that in the control group [(41.2±2.6) vs (45.7±3.1), P=0.001]. Among them, in the field of quality of life symptoms, the scores of patients in the HMB intervention group were better than those in the control group[ (9.1±7.9) vs (15.2±8.2), P=0.008]. The postoperative white blood cell count of the HMB intervention group was lower than the control group [(5.5±1.6)×109/L vs (6.6±1.7)×109/L, P=0.042]. Conclusion Compared with regular oral nutritional supplements, oral nutritional supplements with HMB can improve the overall quality of life and fatigue better, and reduce the overall inflammation level of elderly patients with colon cancer after surgery.
2022 Vol. 9 (2): 229-233 [Abstract] ( 210 ) HTML PDF (975 KB)  ( 234 )
234 Mutation analysis of the SNP site of CHEK2 gene in triple‑negative breast cancer
1Ke Longzhu, 2Tang Dongxin, 2Leng Fuyu, 1Chen Jie, 1Liu Jie, 1Luo Li
Objective To observe the mutation of single nucleotide polymorphism (SNP) in the functional region of CHEK2 gene in triple⁃negative breast cancer (TNBC). Method We Collected wax slices of pathological tissues of 40 TNBC patients who were diagnosed in Guihang Guiyang Hospital and The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from December 2017 to January 2020, and then selected 24 sites on the CHEK2 gene, which is more related to TNBC, and used paraffin DNA extraction. The extraction kit extracts DNA from wax slices of pathological tissues and then undergoes methylation treatment. Use the primer design software PyroMark Assay Design 2.0 to design the primer sequence. After polymerase chain reaction amplification, the candidate SNP sites of the CHEK2 gene functional region are detected by pyrosequencing detection method, and the mutations of the SNP sites are analyzed. Finally, the pyrosequencer comes with the Pyro Q⁃AQ software automatically analyzes the base ratio of each site. Result The 24 SNP sites on the CHEK2 gene of 40 TNBC patients were detected. Among them, D82A and E79G have repeated structures in the sequence, and no qualified primers were designed, so they were not tested. The results showed that the first four mutation frequencies and sample sizes were K131N, K142E, P152S and T366FS, respectively. Among them, K131N, K142E and P152S belong to the fork⁃head related region, while T366FS belongs to the kinase region. The sites where no mutations were detected were T59K, I157T, 1100delC, E394K, Y424C and R475FS.Most samples at R145W site have no mutations, a small number of samples have obvious mutations, and the mutation rate of other sites is low. Conclusion In patients with TNBC, the four loci with higher mutation frequency of CHEK2 gene are K131N, K142E, P152S and T366FS.
2022 Vol. 9 (2): 234-240 [Abstract] ( 182 ) HTML PDF (1762 KB)  ( 212 )
241 Study on risk factors and comprehensive measures of radiation enteritis after concurrent radiotherapy and chemotherapy for cervical squamous cell carcinoma
Zhou Chao, Zhu Ying, Xu Dejing, Huan Jianying
Objective To explore the risk factors and therapeutic effects of concurrent radiotherapy and chemotherapy in patients with cervical squamous cell carcinoma. Method A total of 500 patients with cervical squamous cell carcinoma treated and treated with radical resection in Nanjing Medical University Cancer Hospital from January 2019 to March 2021 were selected. According to the occurrence of radiation enteritis during the same period of radiotherapy and chemotherapy, they were divided into radiation enteritis group and control group. Multivariable Logistic regression analysis were used to determine the influence factors of concurrent chemoradiation radioactive enteritis of the cervical squamous carcinoma patients during the same period. The patients in the radiation enteritis group were given personalized bladder filling training, traditional Chinese medicine retention enema nursing, rational radiotherapy program, psychological nursing and health education and other nursing interventions. To calculate the nursing clinical efficacy of patients with radiation enteritis, and to compare the proportion of patients with radiation enteritis symptom severity≥2 grade before and after nursing intervention. Result 225 cases had radiation enteritis, and the incidence rate was 45%. Multivariate Logistic regression analysis showed that≥60 years old (OR=7.253, 95%CI=3.294-15.970), stage Ⅲ tumor (OR=38.705, 95%CI=12.546-119.410), tumor diameter≥4 cm (OR=11.669, 95%CI=4.868-27.970), average radiation dose≥60 Gy (OR=40.223, 95%CI=14.460-111.883) were risk factors for the occurrence of radiation enteritis during concurrent radiotherapy and chemotherapy, and good nutrition (OR=2.474, 95%CI=1.108-5.527) was a protective factor for the occurrence of radiation enteritis. The therapeutic effect of radiation enteritis in 225 patients was 94.67%. Compared with before intervention, the proportion of symptom severity≥2 grade in 225 patients with radiation enteritis significantly decreased after intervention, 69.33% and 32.00% (P<0.05). Conclusion Age≥60 years, tumor stage Ⅲ, tumor diameter≥4 cm, average radiation dose≥60 Gy are the risk factors for the occurrence of radiation enteritis in patients with cervical squamous cell carcinoma during concurrent radiotherapy and chemotherapy. Good nutrition is a protective factor, and the patients with the above risk factors should be targeted for prevention and intervention.
2022 Vol. 9 (2): 241-246 [Abstract] ( 240 ) HTML PDF (1578 KB)  ( 205 )
247 The role of NETs in the prediction and prevention of cancer‑associated venous thromboembolism
Zhang Yi, Cui Jiuwei
Neutrophil extracellular traps (NETs) are extracellular decondensed chromatin webs decorated with granule proteins post neutrophils activation. In recent years, the pathological role of NETs in the occurrence and development of tumor and related complications has been gradually recognized. Recent studies have suggested that the occurrence of cancer⁃associated venous thromboembolism (VTE) may be related to the overproduction of NETs in cancer patients. The chromatin fiber network, cell⁃free DNA (cfDNA), and histones that constitute NETs contribute to and accelerate thrombosis by participating in the formation of blood hypercoagulable states and endothelial damage. Based on the understanding of the mechanism of NETs formation and how NETs promote VTE, NETs marker P⁃selectin, citrullinated histone H3 and cfDNA are the most promising potential markers for predicting VTE. Inhibition of NETs generation and elimination of NETs are two main directions for preventing VTE caused by abnormal accumulation of NETs. More and more studies have found that heparin, aspirin, chloroquine and other drugs can inhibit the formation of NETs. The discovery of these drugs will help to further reveal the mechanism of NETs formation and how NETs promote VTE, and also contribute to the development of more efficient prevention and treatment strategies for VTE. At the same time, inhibitors of substances that play a key role in the formation of NETs are also expected to reduce the incidence of VTE. Herein, we will mainly discuss the mechanism by which NETs promote tumor⁃associated VTE, and summarize the research progress on prediction and prevention of tumor⁃associated VTE by NETs.
2022 Vol. 9 (2): 247-252 [Abstract] ( 275 ) HTML PDF (1015 KB)  ( 307 )
253 Research progress of therapeutic targets and targeted medicine of aerobic glycolysis
Li Xiaoxin, Wang Min
Aerobic glycolysis, one of the most important metabolic features of tumor cells, can not only provide energy immediately, but also generate a number of glycolytic intermediates which are diverse biosynthetic precursors. More importantly, high flux of glycolysis causes the high⁃lactate, low⁃glucose metabolic environment which is conducive to maintain the immunosuppressive tumor microenvironment. Aerobic glycolysis accompanied with the upregulated key enzymes and transporters which result in increased glucose consumption and lactic acid secretion. Targeting glycolysis⁃related gene can inhibit tumor progression and improve the sensitivity of other therapeutic medicine. The combination of targeted glycolysis therapy and other therapies such as immunotherapy and chemotherapy will be promising in tumor therapy. However, targeted glycolysis therapy has two main challenges: ① metabolic heterogeneity of tumor cells; ② the damage to the immune system. This article reviews the research progress of various targets and their targeted medicine of aerobic glycolysis as well as the difficulties of targeted glycolysis therapy.
2022 Vol. 9 (2): 253-258 [Abstract] ( 1042 ) HTML PDF (1161 KB)  ( 621 )
259 Advances in lncRNA regulation of cholesterol metabolism
Xu Conghui, Sun Yanbo, Xu Pengyuan
Cholesterol is an indispensable component of the structure of cell membranes in the human body, involved in regulating the biophysical properties of cell membranes, and is also a precursor to the synthesis of bioactive molecules such as bile acids, sterol hormones, and oxysterols. Maintaining the metabolic balance of cholesterol is essential for maintaining the life activities of cells and the body. Imbalance of cholesterol metabolism in the human body is a risk factor for many diseases such as atherosclerosis, gallbladder stones, cholestatic liver damage, hypercholesterolemia, myocardial infarction, etc., and plays an important role in the occurrence and development of a variety of tumors. lncRNA does not code for protein, which regulates transcription, translation, mRNA cleavage, post⁃transcriptional modification and other processes to exert its biological effects such as regulating epigenetics, controlling the cell cycle, regulating differentiation and immune response. lncRNA is an important epigenetic regulator in gene expression, in recent years, with the maturity of sequencing and gene chip technology, more and more studies have confirmed the interaction between lncRNA and its regulated protein⁃coding genes, forming a highly complex regulatory network, participating in a variety of life activities and disease progression, and the mutation or expression abnormality of lncRNA has a regulatory effect on the occurrence and development of many diseases. lncRNA has been found to play an important regulatory role in human cholesterol metabolism through a variety of pathways. In this paper, the research progress of lncRNA regulation of cholesterol metabolism and cholesterol metabolism⁃related diseases is reviewed.
2022 Vol. 9 (2): 259-264 [Abstract] ( 250 ) HTML PDF (928 KB)  ( 256 )
265 Research progress of copper and copper‑related proteins in tumors
1Wang Yingqiao, 1Yang Mi, 1Wang Yin, 2Liu Laiyu, 1Guan Jian
As an indispensable trace element in the body, copper is a cofactor on the active sites of a variety of enzymes and participates in energy metabolism, anti⁃oxidation, blood coagulation, neurotransmitter synthesis, iron metabolism, pigmentation and other important life activities. Abnormal copper metabolism can cause serious diseases, such as Menkes disease caused by copper deficiency and hepatolenticular degeneration caused by excessive copper accumulation. The importance and potential toxicity of copper determine that its transportation and distribution in the human body need to be regulated by a complex and sophisticated transport system, which involves a variety of copper chaperones and transport proteins. Therefore, copper is inseparable from its related proteins. The copper level in tumor tissues and serum of patients with cancer is significantly elevated. In recent years, studies on the molecular mechanisms of copper ions and copper⁃related proteins regulating tumor proliferation have become more and more in⁃depth. It is now clear that copper ions and copper⁃related proteins are involved in the occurrence and development of tumors, especially in the activation of signal pathways related to tumor cell invasion and metastasis. In addition, there is crosstalk between copper ion and tumor micro⁃environment, which can jointly regulate tumor proliferation and metastasis. This review will discuss the physiological metabolic pathways of copper in the human body, the effects of copper ions and copper⁃related proteins on the tumor tissue and tumor micro⁃environment, and introduce new therapies that target copper ions and copper⁃related proteins, which could provide new ideas for tumor research, diagnosis and treatment, and provides a strong theoretical basis for the application of copper chelators in tumor treatment.
2022 Vol. 9 (2): 265-270 [Abstract] ( 330 ) HTML PDF (1155 KB)  ( 640 )
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