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2022 Vol. 9, No. 6
Published: 2022-12-09
 
686 Research advances in whole grains and cancer prevention
Liu Junli,Zhao Wei, Liu Jingke
Cancer is the second leading cause of death after cardiovascular disease. The causative factors of cancer are related to a variety of factors including genetic environmental psychosocial and dietary factors of which the impact of dietary factors on cancer has been a major concern. Whole grains retain endosperm germ and bran and are a good source of dietary fiber B vitamins minerals and other nutrients. Epidemiological studies have shown that regular consumption of foods based on whole grains and their products can reduce the risk of cancer such as colorectal cancer breast cancer and esophageal cancer. Much of this health advantage is related to the presence of dietary fibre polyphenols bioactive peptides and other natural functional components in whole grains. The active ingredients in whole grains achieve cancer prevention and treatment by promoting gastrointestinal motility and protecting intestinal health reducing inflammation levels and enhancing immunity reducing obesity risk and improving insulin resistance as well as inducing cancer cell cycle arrest and promoting cancer cell apoptosis among other ways. This paper summarizes the epidemiological evidence of whole grains for cancer prevention as well as the preventive and therapeutic effects of dietary fiber active peptides and phenolics on cancer and describes the underlying mechanisms aiming to provide a scientific basis for improving the dietary intake of whole grains.
2022 Vol. 9 (6): 686-692 [Abstract] ( 226 ) HTML PDF (1039 KB)  ( 195 )
693 Nutrition to the end
Wang Lin, Shi Hanping
Despite the rapid growth of science and technology the incidence rate of malnutrition has kept rising instead of decreasing. Malnutrition is one kind of dysfunction of multiple organs and systems. The causes adverse consequences and therapeutic effects of malnutrition are multi-dimensional including physiological psychological social spiritual and economic aspects. Therefore nutrition requires department cooperation and high attention from the whole society. The author appeals to carry out nutrition to the end and to promote nutrition development and progress with the following 9 suggestions ①starting from nutrition education improve the scientific cognition and literacy of nutrition ②starting from nutritional diagnosis promote clinical nutrition to the medical routine ③starting from disease treatment promote nutrition to the tertiary prevention of disease ④starting from hospital nutrition promote nutrition to communities and families ⑤starting from pregnancy nutrition promote nutrition to the whole life process ⑥starting from physiological nutrition promote whole person nutrition ⑦starting from table nutrition promote the nutrition industry ⑧starting from personal nutrition promote nutrition in China ⑨starting from finding problems promote nutrition research.
2022 Vol. 9 (6): 693-695 [Abstract] ( 248 ) HTML PDF (858 KB)  ( 389 )
696 Interpretation of Guidelines for nutritional treatment pathways for adult patients in China Implantable Venous Access Port PORT
Wang Lu, Jiang Hua
Parenteral nutrition PN is irreplaceable in clinical nutrition support treatment and it is also the main way of nutritional support for patients who cannot orally eat for a long time. For patients with chronic wasting diseases especially those with short bowel syndrome the advancement of home PN has greatly increased the chances of survival. After more than 40 years of development clinicians should consider the patient's quality of life in addition to reducing complications and improving nutritional intake when choosing the path of PN. Implantable venous access port PORT is a closed intravenous infusion device that is completely implanted in the human body and placed under the skin. It has the advantages of low risk of infection high convenience in life simple maintenance and long service life. It is currently often used for patients who require long - term infusion therapy and multiple hospitalizations because it can minimize the irritation of drugs to patients' blood vessels. It has been proved that patients only need to receive a small operation of 15-20 minutes to implant the PORT with low maintenance cost of 6000-8000 yuan. And a PORT can be used repeatedly for more than 10 years on average. Based on the suitable population indications implantation methods and routes of the infusion port this article proposes guiding opinions on the use of the infusion port in clinical work and explores the possibility of the infusion port in the long-term parenteral nutrition use of adult patients.
2022 Vol. 9 (6): 696-700 [Abstract] ( 302 ) HTML PDF (883 KB)  ( 285 )
701 Research progress on the relationship between sarcopenia and carcinogenesis
Xu Lamei, Gao Shuqing
At present the onset of most cancers is hidden and the diagnosis is mostly in the middle and late stage. The treatment means are very limited and complex. Therefore it is particularly important to identify and control the risk factors for cancer to prevent the occurrence of cancer. As for the risk factors of cancer in addition to the well - known ionizing radiation tobacco alcohol consumption bacterial and viral infections some factors closely related to sarcopenia such as reduced physical activity and metabolic syndrome have also been considered to be related to the development of cancer. Sarcopenia is mainly related to inflammation oxidative stress injury immune dysfunction metabolic syndrome and dysregulation of muscle regulators. In recent years it has been found that the immune dysregulation insulin resistance and chronic inflammation caused by sarcopenia are directly or indirectly related to the occurrence of some cancers. However at present there is a lack of relevant research involving fewer types of cancer and there is no systematic description and summary of the mechanism of cancer secondary to sarcopenia. Therefore this article will review the relationship between sarcopenia and the risk of different types of cancer and the possible mechanism of sarcopenia leading to cancer so as to provide a theoretical basis for the prevention of sarcopenia-related cancer.
2022 Vol. 9 (6): 701-706 [Abstract] ( 285 ) HTML PDF (1542 KB)  ( 424 )
707 Research progress in tumor prevention of racemic equol and its enantiomeric
Dou Yuqi, Chen Botian, Ma Defu
Equol a metabolite of daidzein has the strongest antioxidant activity among soybean isoflavones and its metabolites. It has two enantiomers. More and more studies have shown that the antitumor effect of soybean isoflavone depends on its metabolite equol. However the preventive effect of equol and its enantiomers on various types of tumors is not uniform and the underlying mechanism is not clear. Observational studies of equol and tumor outcomes suggest that dietary habits soy intake equol phenotype and ethnicity may be major contributors influencing the results. Animal studies to obtain the carcinogenic effects of R- and S -Eq in sufficient amounts and human intervention studies to directly address the effects of equol enantiomers on intermediate biomarkers of cancer risk may help to further define the impact of equol producers on phenotype and the mechanism of action of Eq itself. However it is certain that equol as a metabolite of soybean isoflavone has higher anti-tumor activity wider anti-tumor targets and lower toxicity than its precursors which plays an important role in protecting human health and preventing diseases. Subsequent studies should further explore the effects of different races different phenotypes and different doses of equol on the risk of tumorigenesis so as to provide a basis for rational application of equol.
2022 Vol. 9 (6): 707-713 [Abstract] ( 258 ) HTML PDF (1383 KB)  ( 182 )
714 Research progress on the mechanism prevention and treatment of obesity-related tumors
Chen Xiyu, Chen Jinghao,Yang Yanling
Obesity and overweight increase the risk and worsen the prognosis of cancer and are the primary risk factors for numerous diseases such as cardiovascular disease type 2 diabetes and metabolic syndrome. Obesity has been shown to be an independent risk factor for some cancers including breast cancer endometrial cancer ovarian cancer gastric cancer colorectal cancer renal cancer esophageal adenocarcinoma pancreatic ductal adenocarcinoma and liver cancer. The mechanism of obesity - promoting cancers which largely focuses on insulin resistance fat factor imbalance sex hormone imbalance systemic inflammation immune system alterations and intestinal flora imbalance after obesity is poorly understood. These systems interact and support carcinogenesis on the basis of inflammation they do not function independently. Most of the effects of obesity on the development and mortality of cancer can be prevented by adjusting diet and increasing physical exercise. Anti-inflammatory-based drug therapy can be used as a priority strategy for prevention and bariatric surgery also provides more options for preventing and treating obesity-related cancer. The mechanism by which obesity and overweight contribute to the formation and development of cancer will be discussed in this article along with future strategies for treating and preventing cancer in obese people.
2022 Vol. 9 (6): 714-720 [Abstract] ( 292 ) HTML PDF (3222 KB)  ( 218 )
721 The relationship between dietary patterns and cancer and its mechanism of action
1Gu Ying,2Yang Jing,3Qin Liqiang
As we all know diet is closely related to cancer. Healthy diet pattern can reduce the risk of some cancers while inappropriate diet structure may be an important inducement leading to systemic metabolic diseases such as tumors. In recent years more and more studies have explored the influence of different diet patterns on the morbidity mortality and treatment effect of tumors. This paper combs several diet patterns that have attracted much attention at present Including the relationship between Mediterranean diet Ketogenic diet and Pro-inflammatory diet and tumor and the possible mechanism of action. The results show that Mediterranean diet can reduce the incidence and overall mortality of colorectal cancer prostate cancer respiratory and digestive system cancer breast cancer oropharyngeal cancer oral cancer and throat cancer by regulating hormone levels activating antioxidant mechanism stimulating immune system and down-regulating carcinogenic factors. Ketogenic diet mode may slow down tumor growth by targeting glucose metabolism amino acid metabolism mitochondrial metabolism regulating gene expression regulating signal pathway and reducing vascularization level. It plays an important role in prolonging the survival time of patients and reversing the process of tumorinduced cachexia and has gradually become an effective anti-cancer treatment. The Pro-inflammatory diet contains more inflammatory components which may promote the occurrence and development of tumors by increasing the inflammatory level changing the state of microflora and affecting epigenetic remodeling.
2022 Vol. 9 (6): 721-726 [Abstract] ( 341 ) HTML PDF (1478 KB)  ( 301 )
727 Principles in cancer nutrition therapy
1Wang Lin,2Cong Minghua,3Cui Jiuwei,4Xu Hongxia,5Chen Junqiang,6Li Tao,7Li Zengning,8Liu Ming,3Li Wei,9GuoZengqing,10Song Chunhua,11Weng Min,12Zhang Qi,2Zhang Xi,2Tang Meng
Cancer nutrition therapy can significantly improve clinical outcomes prolong survival time improve quality of life and save medical costs. It should be used as the first - line and basic treatment for cancer patients throughout the whole process of treatment. The cancer patients should start the nutrition therapy entirely and actively at an early stage. According to the nutritional diagnosis nutrition therapy should be implemented correspondingly following the four priority principles of dietary priority oral priority nutritional education priority and enteral nutrition priority and the five - step nutrition therapy specification of nutritional education oral nutritional supplements ONS tube feeding partial parenteral nutrition PPN and total parenteral nutrition TPN . The basic requirement of cancer nutrition therapy is to meet the energy and nutrient requirements of cancer patients and the highest goal is to regulate metabolism control cancer maintain body functions improve quality of life and extend survival time. The total energy requirement is assessed using 20-25 kcal / kg·d for bedridden patients and 25-30 kcal / kg·d for active patients and the protein supply is assessed using 1. 2-1. 5 g / kg·d . The energy supply ratio of glucose and fatty acid should be adjusted in the light of the insulin resistance of patients. It is suggested that tumor-bearing patients should reduce the proportion of glucose and increase fatty acid. The combination of multiple pharmacological nutrients has a positive effect on cancer patients. Nutrition therapy for endstage cancer patients requires individualization and full respect for the opinions of patients and their families.
2022 Vol. 9 (6): 727-734 [Abstract] ( 415 ) HTML PDF (3531 KB)  ( 606 )
735 Expert consensus on nutritional treatment for patients with colorectal cancer
Colorectal cancer is one of the most common tumors and patients with colorectal cancer often suffer from malnutrition and weight loss. Affected by reduced intake intestinal obstruction and malabsorption malnutrition is more common in colorectal cancer patients than in non - gastrointestinal tumor patients. Patients with colorectal cancer should undergo nutritional risk screening 2002 NRS 2002 and patient-generated subjective globe assessment PG-SGA . The European Society for Parenteral and Enteral Nutrition ESPEN strongly recommends enhanced recovery after surgery ERAS for all tumor patients undergoing radical or palliative surgery. ERAS can reduce the incidence of complications after colorectal surgery promote rehabilitation and shorten hospital stay. In the ERAS protocol ESPEN recommends that every patient should be screened for nutritional risk and if there is nutritional risk additional nutritional support should be given for patients with severe malnutrition nutritional intervention should be carried out for at least 10-14 days before operation even at the cost of delaying operation. Different surgical methods will have different effects on the incidence of postoperative complications mortality and 3-year long-term survival rate of colorectal cancer patients. Clinicians should pay attention to the nutritional status of patients after discharge reasonably carry out nutritional intervention and follow the patients with nutritional risk at discharge in a planned way.
2022 Vol. 9 (6): 735-740 [Abstract] ( 612 ) HTML PDF (947 KB)  ( 772 )
741 Analysis of the nutrition - related risk factors in unplanned reoperation related to abdominal and pelvic cavity and digestive tract
Zhang Hongmei, Han Xiaoyun, Xu Xiaoqing
Objective To explore risk factors of unplanned reoperations in patients with malignant tumors of abdominal pelvic cavity and digestive tract based on controlled nutritional status score. Method The clinical data of patients underwent unplanned reoperation who treated in Medical Administration of the Affiliated Cancer Hospital of Shandong First Medical University from January 2020 to December 2021 were retrospectively collected and each operation was matched in a ratio of 1 ∶ 1 as a case -control study object. Univariate analysis was done by χ 2 or t test and multivariate analysis was performed by conditional logistic regression. Result The incidence of unplanned reoperation in our hospital from 2020 to 2021 was 0. 68% . The results of Univariate analysis showed that COUNT≥4 anemia and hypo-albuminemia before operation weight loss ≥2 kg in 1 month before operation operation duration ≥5 h blood loss ≥250 ml during surgery were risk factors P < 0. 05 . Conditional logistic regression multivariate analysis showed that CONUT score blood loss ≥250 ml during surgery and weight loss ≥2 kg in 1 month before operation were independent risk factors for unplanned reoperation. Conclusion Poor immunonutrition status before operation is a independent risk factor for unplanned reoperation of abdominal pelvic and gastrointestinal tract. Effective intervention on independent risk factors can reduce incidence of unplanned reoperation in future and improve prognosis.
2022 Vol. 9 (6): 741-746 [Abstract] ( 251 ) HTML PDF (929 KB)  ( 150 )
747 The relationship between NuSAP1 LDLR and axillary lymph node metastasis in patients with locally advanced breast cancer and its risk factors analysis
1Chen Xinkuan,1Yang Haiyan,2Liang Wei
Objective To investigate the relationship between nucleolar spindle - associated protein 1 NuSAP1 low - density lipoprotein receptor LDLR and axillary lymph node metastasis in patients with locally advanced breast cancer and analyze the risk factors for axillary lymph node metastasis ≥ 10. Method A total of 125 patients with locally advanced breast cancer who were diagnosed and treated in our hospital from January 2018 to April 2022 were selected as the research subjects. The tumor tissues and adjacent tissues were collected during operation and the expressions of NuSAP1 mRNA and LDLR mRNA were detected. The expressions of NuSAP1 mRNA and LDLR mRNA in cancer tissues of patients with different axillary lymph node metastasis were compared. The correlation between NuSAP1 mRNA and LDLR mRNA expression and axillary lymph node metastasis was analyzed. Binary Logistic regression model was used to analyze the risk factors of axillary lymph node metastasis ≥ 10. Result The expressions of NuSAP1 mRNA and LDLR mRNA in cancer tissues were higher than those in adjacent tissues P< 0. 05 . With the increase in the number of axillary lymph node metastases the expression of NuSAP1 mRNA and LDLR mRNA in cancer tissues increased P<0. 05 . The expression of NuSAP1 mRNA and LDLR mRNA in cancer tissue was positively correlated with the number of axillary lymph node metastasis P<0. 05 . After adjusting for clinical stage and maximum tumor diameter high expression of NuSAP1 mRNA and LDLR mRNA in cancer tissue were still independent risk factors for axillary lymph node metastasis ≥ 10 in breast cancer patients P<0. 05 . Logistic regression model was established logit P = -6. 004+ 1. 298×LDLR mRNA+ 1. 141×NuSAP1 mRNA. Conclusion NuSAP1 mRNA and LDLR mRNA expressed highly in cancer tissues of patients with locally advanced breast cancer and the expression levels are closely related to the number of axillary lymph node metastases in patients.
2022 Vol. 9 (6): 747-752 [Abstract] ( 225 ) HTML PDF (1068 KB)  ( 144 )
753 Correlation between malnutrition and inflammatory markers and prediction of risk factors in elderly patients with liver cancer
1Wang Aiying,2Yao Wenjing, 2Shu Xiao
To investigate the correlation between malnutrition and peripheral blood inflammatory indexes in elderly patients with liver cancer with interventional chemoembolization TACE and to establish a related prediction model. Method A total of 120 elderly patients with liver cancer who were admitted to the hospital from May 2020 to May 2022 were selected as the research subjects all of whom underwent TACE. After operation the nutritional status of the patients was evaluated according to the overall nutritional assessment scale and the patients were divided into a malnutrition group score of 2 - 21 and a non - malnutrition group score of 0-1 . The peripheral inflammatory indexes interleukin-6 IL-6 IL-8 C-reactive protein CRP tumor necrosis factor-α TNF-α were compared between the two groups. The Spearman correlation coefficient was used to analyze the correlation between malnutrition and the above indicators in elderly TACE patients. The relevant data of the two groups of patients were collected the logistic regression model was used to screen the risk factors of postoperative malnutrition in elderly TACE patients the prediction model was established and the receiver operating characteristic ROC curve was drawn to analyze the clinical application value of the prediction model. Result 76 of the 120 patients were malnourished after TACE. The levels of serum IL-6 IL-8 CRP and TNF-α in the malnutrition group were higher than those in the non-malnutrition group P<0. 05 . Malnutrition in elderly TACE patients was positively correlated with peripheral blood inflammatory indexes IL-6 IL-8 CRP and TNF-α P<0. 05 . The BMI preoperative nutritional support ratio ALB and PAB in the malnutrition group were lower than those in the non -malnutrition group and the proportions of anemia viral hepatitis B anxiety and depression and cancer - related fatigue were higher than those in the non - malnutrition group P< 0. 05 . Elevated IL - 6 IL - 8 CRP TNF - α anemia no preoperative nutritional support anxiety and depression cancer-related fatigue and decreased ALB were independent risk factors for malnutrition in elderly TACE patients P< 0. 05 . The AUC value of the risk prediction model for predicting malnutrition in elderly TACE patients was 0. 899 and the sensitivity and specificity were 88. 4% and 87. 1% respectively. Conclusion Malnutrition is positively correlated with peripheral blood inflammatory indexes in elderly patients with liver cancer TACE. The established risk prediction model can be used to predict the risk of malnutrition in elderly patients with liver cancer after TACE.
2022 Vol. 9 (6): 753-758 [Abstract] ( 150 ) HTML PDF (936 KB)  ( 355 )
759 Effects of oral nutritional supplement therapy on nutritional status and immune function for patients with ovarian cancer undergoing postoperative chemotherapy
Sun Lan, Sun Yujuan, Dong Ruofan, Xia Ling
To evaluate the effects of oral nutritional supplement therapy ONS on nutritional status and immune function for patients with ovarian cancer after surgical resection and routine intravenous chemotherapy and put forward a reasonable nutritional supply scheme. Method A total of 102 patients with ovarian cancer who were admitted to Affiliated Hospital of Jiangnan University from January 2018 to December 2021 were prospectively selected by clinical randomization case-control method and all of them were treated with surgical resection and conventional intravenous chemotherapy. Then they were randomly divided into control group and test group with 51 patients in each group. The control group was given routine nutrition guidance and the test group was given ONS Ensure ® 250 ml 1. 06 kcal containing 0. 0356 g protein per mL produced by Abbott Laboratories in the United States 3 times/ d for 15 weeks. The body mass body mass index BMI serum lymphocyte count erythrocyte count hemoglobin albumin and total protein levels before discharge 3 weeks 9 weeks and 15 weeks after discharge as well as the Patient generated subjective overall assessment PG-SGA score were compared between the two groups. Result 48 patients in the control group and 49 patients in the test group finally completed the clinical follow-up. The general clinical datas of the two groups were comparable P > 0. 05 . The body mass and BMI of the test group were significantly higher than those of the control group after 9 and 15 weeks follow-up the levels of serum lymphocyte count erythrocyte count hemoglobin albumin and total protein were significantly higher than the control group and the PG-SGA score was significantly lower than the control group too P < 0. 05 . Conclusion Patients with ovarian cancer have a higher risk of malnutrition after surgical resection and routine intravenous chemotherapy. Routine ONS is of positive significance to improve the nutritional and immune status of the body which is worthy of clinical application.
2022 Vol. 9 (6): 759-764 [Abstract] ( 151 ) HTML PDF (906 KB)  ( 194 )
765 Construction and evaluation of a nomogram prediction model for periradiotherapy malnutrition risk in patients with esophageal cancer
1Xi Conglin,1Wang Liqing,1Dai Lingling,2Xu Fang,1Yan Suhua,1Ding Ying,1Yang Fei,3Sun Caifeng,1Dong Xiantao,1Zhang Yongjie
To construct a nomogram prediction model for the risk of malnutrition in patients with esophageal cancer EC during periradiotherapy and to evaluate the predictive performance of the model. Method From March 2019 to March 2022 194 EC patients who underwent radiotherapy in our hospital were taken One day after radiotherapy scored Patient-generated Subjective Global Assessment PG-SGA and serum albumin level were used for malnutrition screening. According to the presence or absence of malnutrition they were grouped into a malnutrition group PG-SGA score ≥4 and serum albumin <35 g / L and a good nutrition group PG-SGA score <4 or serum albumin ≥35 g / L . Multivariate Logistic regression analysis was applied to determine the influencing factors of malnutrition risk in EC patients during periradiotherapy and a nomogram prediction model was constructed based on the predictive factors and then the discriminativeness and precision of the model were verified by the area under the ROC curve AUC and H - L goodness of fit. Result Malnutrition occurred in 83 EC patients and the incidence of malnutrition was 42. 78% univariate analysis showed that there were significant differences between the malnutrition group and the good nutrition group in 9 factors including age thin monthly household income per capita whether to undergo surgery tumor stage the number of accompanying gastrointestinal symptoms concurrent chemotherapy dysphagia and depression P < 0. 05 Logistic regression analysis showed that the risk factors of malnutrition in EC patients during periradiotherapy were age ≥ 60 years old weight loss tumor stage > stage Ⅱ number of accompanying gastrointestinal symptoms ≥ 2 concurrent chemotherapy and dysphagia P < 0. 05 regression formula of malnutrition assessment in EC patients during periradiotherapy Logit P = -11. 563+0. 958×age+1. 167×weight loss+ 0. 915 × tumor stage + 0. 903 × number of accompanying gastrointestinal symptoms + 1. 306 × concurrent chemotherapy + 0. 839 × dysphagia the above 6 risk factors were introduced into R software to establish a nomogram model the AUC was 0. 786 > 0. 75 95%CI = 0. 722-0. 850 the calibration curve and the ideal curve fit well and goodness-of-fit H-L test χ 2 = 7. 114 P = 0. 524 indicating that the nomogram model has good discrimination and accuracy in predicting malnutrition in EC patients during periradiotherap. Conclusion The nomogram prediction model constructed based on six factors including age ≥60 years weight loss tumor stage >Ⅱ number of accompanying gastrointestinal symptoms ≥2 concurrent chemotherapy and dysphagia has a good effect on the risk of malnutrition in EC patients during periradiotherapy The predictive role of esophageal cancer can provide reference for oncology medical staff to take preventive nursing intervention in the periradiotherapy period of esophageal cancer patients in a timely manner.
2022 Vol. 9 (6): 765-771 [Abstract] ( 146 ) HTML PDF (1762 KB)  ( 182 )
772 Effects of preoperative maltodextrin fructose solution on insulin resistance in patients with gastric cancer surgery
Xue Yinghui,Zhou Moling,Gong Zhifu, Zhou Chengwei, Qiao Yuan, Li Linlin
To investigate the effect of preoperative maltodextrin fructose solution on the diversity of gastric microflora and intestinal function. Method Select 100 gastric cancer patients requiring surgical treatment in our hospital from May 2021 to April 2022. They were divided into control group and experimental group by random number table method 50 cases in each group. The control group routinely fasted for 8 - 12 hours before surgery and fasted for 2 hours. The experimental group adopted the preoperative intervention of enhanced recovery after surgery ERAS concept maltodextrin fructose solution was administered 10 hours before surgery and maltodextrin fructose solution was administered 2 hours before surgical anesthesia . The general data blood glucoserelated indicators intestinal flora diversity intestinal function and complication rates were compared between the two groups. Result One week after operation the fasting insulin concentration and insulin resistance index of the experimental group were lower than those of the control group and the insulin sensitivity index was higher than that of the control group t = 9. 017 33. 522 3. 216 P<0. 01 < 0. 01 0. 002 One week after operation the Chao1 index and Shannon index of the experimental group were higher than those of the control group and the time to the first exhaust and the time to the first defecation were shorter than those in the control group t = 2. 720 6. 540 3. 344 3. 578 P= 0. 008 <0. 01 0. 001 0. 001 . There was no significant difference in surgical data operation time surgical bleeding surgical method etc. between the two groups P> 0. 05 . Conclusion Preoperative maltodextrin fructose solution can effectively improve postoperative blood glucose level and intestinal flora diversity thereby improving intestinal function without increasing the incidence of complications.
2022 Vol. 9 (6): 772-777 [Abstract] ( 236 ) HTML PDF (1436 KB)  ( 258 )
778 Impact of lean body mass on prognosis in patients with hematological malignancies
1Zhang Ling,2Liu Yu,1Huo Zhenyu,1Fan Yang,1Zhang Mengyuan,1He Xiumei,1Liu Jie,1Xu Hongxia,1Chong Feifei
To investigate the effect of lean body mass on the survival and prognosis of patients with hematological malignancies including leukemia lymphoma and multiple myeloma . Method 312 patients with hematological malignancies from January 2014 to February 2020 were enrolled in a single center. Subjective global assessment PG- SGA and body composition analysis BiodynamicsBIA450 were performed within 48 hours after admission. Male lean body mass P15 = 35. 7 kg female lean body mass P15 = 28. 7 kg for grouping males ≤35. 7 kg were included in low lean body mass reorganization females ≤28. 7 kg were included in low lean body mass reorganization. The basic conditions of the research subjects were compared and the biochemical indicators anthropometric indicators and survival conditions were compared between the two groups. Result Among 312 patients 262 patients with normal lean body weight were classified as normal lean body group and other 50 patients with low lean body weight were classified as low lean body group. In leukemia patients the albumin and lymphocyte of normal lean body mass group were significantly higher than those of low body mass group P<0. 05 . In addition in patients with multiple myeloma and malignant lymphoma there was a statistical correlation between body measurements BMI MAC TSF MAMC and CC and lean body mass group P<0. 05 . Kaplan-Meier survival curve and Log-rank test showed that the survival rate of low lean body group was lower than that of normal lean body group P<0. 001 Cox regression analysis showed that low lean weight was a risk factor for hematological malignancies total HR= 2. 361 95%CI = 1. 455-3. 834 malignant lymphoma HR = 2. 331 95% CI = 1. 213-4. 477 multiple myeloma HR = 6. 348 95%CI = 1. 579-25. 520 . Conclusion Lean body mass in patients with hematological malignancies significantly affects the prognosis and survival of patients. It is recommended to strengthen individualized nutritional intervention to improve low lean body mass and improve the prognosis of patients.
2022 Vol. 9 (6): 778-785 [Abstract] ( 178 ) HTML PDF (2418 KB)  ( 298 )
786 Prognostic value of the Global Leadership Initiative on Malnutrition GLIM -defined malnutrition for gastric cancer patients
Xu Tingting, Wang Chenchen,Lu Yingying,Zhang Yan
The purpose of this study was to investigate the clinical value of Global Leadership Initiative on Malnutrition GLIM criteria and evaluate the relationship between GLIM-defined malnutrition and survival outcome of gastric cancer patients. Method Totally 174 gastric cancer patients who underwent radical resection at the Department of Gastrointestinal Surgery in our hospital from January 2017 to December 2021were selected as the research participants. Body mass index BMI and the third lumbar skeletal muscle index SMI were used as phenotypic criteria of GLIM consensus for the evaluation of nutritional status and the diagnosis of malnutrition. The effects of GLIM-defined malnutrition on the prognosis of gastric cancer patients were estimated by KaplanMeier method and the univariate and multivariate Cox regression analysis. Result Nutritional risk screening at admission showed that 80 46. 0% of 174 gastric cancer patients were at risk of malnutrition NRS 2002 ≥3 . According to the GLIM criteria it was found that 57 32. 8% of 174 gastric cancer patients were diagnosed with malnutrition before surgery and low BMI was observed in 24 13. 8% patients and reduced muscle mass was observed in 51 29. 3% patients. BMI 20. 4 ± 2. 5 vs 23. 5 ± 3. 4 kg / m 2 t = 6. 093 P<0. 001 SMI 37. 9 ± 4. 2 vs 46. 2 ± 7. 9 cm 2 / m 2 t = 7. 424 P<0. 001 hemoglobin concentration 125. 0 ± 18. 0 vs 136. 0 ± 20. 0 g / L t = 3. 333 P= 0. 001 and serum albumin level 36. 7 ± 4. 6 vs 39. 0 ± 3. 9 g / L t = 2. 470 P= 0. 014 were significantly lower in patients with GLIM-defined malnutrition than in those without malnutrition. Survival analysis indicated that the 5-year disease-free survival DFS rates of patients with and without malnutrition based on the GLIM criteria were 49. 8% and 75. 6% respectively χ 2 = 7. 502 P = 0. 006 . Subgroup analysis showed that GLIM - defined malnutrition was significantly associated with worse DFS of stage Ⅲ patients. The 5 -year DFS rates of patients with and without malnutrition were 31. 7% and 69. 2% with a significantly statistical difference χ 2 = 12. 523 P<0. 001 . In addition the univariate and multivariate Cox regression analysis demonstrated that GLIM - defined malnutrition HR = 2. 180 95% CI = 1. 288 - 3. 687 P = 0. 004 TNM stage HR = 2. 216 95% CI = 1. 245 - 3. 947 P = 0. 007 and Borrmann classification HR = 2. 171 95% CI = 1. 019 - 4. 624 P = 0. 044 were independent prognostic factors for gastric cancer patients. Conclusion GLIM criteria could reflect the nutritional status of gastric cancer patients and it could be used as an effective tool for prognostic assessment.
2022 Vol. 9 (6): 786-793 [Abstract] ( 202 ) HTML PDF (2113 KB)  ( 227 )
794 The significance of prognostic nutritional index in the prognosis of patients with esophageal cancer undergoing radiotherapy and the construction of predictive model
Feng Dan,Wang Guangming
To explore the prognostic nutritional index PNI in patients with esophageal cancer undergoing radiotherapy and to establish an associated nomogram risk model. Method Patients with esophageal cancer who received radiotherapy in our hospital from March 2018 to October 2019 were selected as subjects. PNI was calculated according to the laboratory examination data within one week before the first radiotherapy. The best cut-off value of PNI was calculated by ROC curve and patients were divided into low PNI group and high PNI group. The clinical characteristics of the two groups were compared. Univariate and Cox regression were used to analyze the factors influencing the prognosis of patients with esophageal cancer radiotherapy. Result The optimal PNI cut-off value was 48. 03. There were statistically significant differences in age TNM stage and tumor diameter between the low PNI group and the high PNI group P<0. 05 . High TNM stage tumor diameter ≥3 cm prescription dose < 60 Gy and PNI < 48. 03 were independent risk factors for death in patients with esophageal cancer radiotherapy P < 0. 05 . The results of model verification showed that the C-index was 0. 846 the calibration curve was close to the ideal curve and the AUC of ROC curve was 0. 881 95%CI = 0. 847-0. 912 indicating that the model had good predictive ability. Conclusion PNI has a high predictive value for the prognosis of patients with esophageal cancer radiotherapy and the nomogram model constructed based on PNI can effectively predict the risk of death in patients with esophageal cancer radiotherapy.
2022 Vol. 9 (6): 794-799 [Abstract] ( 172 ) HTML PDF (1658 KB)  ( 229 )
800 Development and application of postbiotics
1Shi Jiangmin,1Shi Dibang,1Xue Yilang,2Luo Ming,3Ruan Chuanxian,3Ruan Weidi,3Wang Fangyan
Since Katerina Tsilingiri proposed the concept of 􀆵postbiotics in 2013 its definition has undergone several changes. Recently the International Scientific Association for Probiotics and Prebiotics ISAPP issued a widely-accepted definition 􀆵Postbiotics is a preparation of inanimate microorganisms and / or their components that confers a health benefit on the host . This paper reviews its preparation techniques biological activities and characteristic advantages. In recent years based on conventional postbiotic preparation techniques new technologies such as technical association pasteurization supercritical carbon dioxide and pulsed electric field have emerged furthemore the postbiotic preparation techniques of symbiotic flora have become mature and the related products exhibited certain efficacy in clinical trial. A lot of literatures confirm that postbiotics enhance health in a multidimensional manner. This review highlights the functional properties of postbiotics such as regulating intestinal flora protecting gastrointestinal mucosa improving immune homeostasis including improving body immunity and preventing allergic diseases inhibiting inflammatory response antioxidant response inhibiting tumor cell proliferation assisting conventional tumor treatment treating neuropsychiatric diseases and regulating metabolism including hypoglycemia hypolipidemia etc. we also tried to elaborate the possible mechanisms on medical application and to share with the readers. Compared with active probiotics postbiotics have more obvious advantages in terms of stability safety colonization free and applicability which make them show more significant potential for development and prospects for application.
2022 Vol. 9 (6): 800-807 [Abstract] ( 314 ) HTML PDF (1423 KB)  ( 655 )
808 Advances of body composition analysis in clinical application of cancer patients
Liu Yining,Cui Jiuwei
Body composition refers to the proportion of various body components muscle adipose tissue skeletal muscle tissue etc. which is a symbol to measure the distribution of tissues in the body one of which can make a great difference on body health or disease. 40%-80% of tumor patients are prone to be complicated with malnutrition and even progress to cachexia. The occurrence of malnutrition seriously affects the survival and prognosis of tumor patients and reduces their tolerance and sensitivity to radiotherapy and chemotherapy. During the occurrence development and treatment of tumors the relevant body composition indexes often vary with the changes of patients' nutritional status the degree of malignancy of the disease the rate of progression and the adjustment of therapy. Therefore human composition as an important monitoring index is related to the survival prognosis analysis and drug toxicity evaluation of patients. Well body composition analysis is an important way to assess the nutritional status of tumor patients and predict their quality of life early which is helpful to make individualized treatment according to the current status of patients. With the widespread use of noninvasive body composition measurements body composition analysis has unique advantages in diagnosis and evaluation of nutritional status of cancer patients prediction of efficacy and toxicity of anti - tumor drugs as well as survival and prognosis. A number of clinical trials related to body composition in cancer patients have been conducted in this article we provide an overview of the clinical application of body composition analysis in cancer patients.
2022 Vol. 9 (6): 808-815 [Abstract] ( 226 ) HTML PDF (1448 KB)  ( 227 )
816 Research advances of the links between cancer cachexia and gut microbiota
1Zhu Junhao,2Wang Meng
Cancer cachexia is a multifactorial chronic wasting metabolic syndrome characterized by unplanned weight loss local or systemic inflammation and progressive muscle wasting which has a strong impact on patients􀆶 physical and mental health and the quality of life. And it is also one of the main causes of cancer deaths among cancer patients. The pathogenic mechanism of cancer cachexia is complicated. Now as people attach importance to the pathogenic mechanism of cancer cachexia there has been lots of studies that have proved the potential links between cancer cachexia and gut microbiota. The muscle-gut axis and the microbiota-brain-gut axis may play an important role in the links. Probiotic and prebiotic therapies have been proved effective on animal models. And fecal microbiota transplantation is also a potential method to cure cancer cachexia . In this article we foucs on the links between gut microbiota and the pathogenic mechanism of cancer cachexia. We also discuss the therapies about gut microbiota and these findings suggest that gut microbiota represents a therapeutic target in cancer cachexia. Finally we explore the shortcomings and the prospects in this research field . With further research we may know more about the specific relationship between cancer cachexia and gut microbiota and offer more effective treatment recommendations.
2022 Vol. 9 (6): 816-821 [Abstract] ( 145 ) HTML PDF (972 KB)  ( 395 )
822 Effects of glutamine on nutritional therapy of radiation-induced oral mucositis
1Wang Shu'an,1Gao Bo,2Yan Jing,2Wang Juan,2Yang Mi,1Chen Xiaotian,3Yang Jiayao
Radiation-induced oral mucositis is the most common complication of radiotherapy for head and neck neoplasms. The relevant symptoms include oral pain dysphagia decreased diet intake and secondary infection which can lead to the interruption of treatment and even affect the clinical efficacy and quality of life. But so far there has been no effective treatment for the clinical management of radiation-induced oral mucositis and the treatment of patients with prevention pain and nutrition is mainly supported by treatment. In recent years glutamine as a kind of immunonutrient substance has become a research hotspot in the prevention of radiation-induced oral mucositis and has been mentioned in the guidelines of various countries which is currently in a stage of strong consensus but absence of abundant evidence. In terms of Nutriology glutamine is a non-essential amino acid and the most abundant free amino acid in the human body. In normal functioning the liver and skeletal muscle are the major organs that synthesize and store glutamine. While the main sites of glutamine consumption are brain tissue mucosa immune cells etc. Cancer patients are in a state of high catabolism of nutrients with an increased demand for glutamine but a decreased synthesis. Glutamine can not be timely replenished to the mucosa and immune cells which may have a negative impact on the prevention and treatment of radiation-induced oral mucositis. Based on current researches on radiotherapy—induced mucosal injury and the repair of glutamine on wound healing pathophysiology the mechanism of glutamine clinical research and application for radiotherapy—induced mucosal injury were reviewed aiming to provide references for clinical practice.
2022 Vol. 9 (6): 822-826 [Abstract] ( 237 ) HTML PDF (2578 KB)  ( 358 )
827 Research progress of food for special medical purpose related to cancer in China
Liu Haitao, Yue Liduo,Li Ming, Fan Lihong
Malignant tumor has become a serious challenge against fitness of human-being and the most common complication of tumor patients is malnutrition which extremely shortens the survival time of patients. Furthermore society is subject to huge adverse impact. In consequence it is of great significance to improve malnutrition for cancer patients. Food for special medical purpose FSMP is easy to digest and absorb according to different types of nutrients through scientific formula and has good adaptability to patients. It can preserve the digestion and absorption function of patients to a greater extent and can be used as a way of nutritional support. There is prominent discrepancy between tumor cells and normal cells in metabolism. FSMP can provide enough nutrition and energy for normal cells while improving tumor microenvironment disrupting tumor metabolism and inhabiting tumor growth. However at present the formulation of special medical food for cancer patients at home and abroad has not formed a systematic individualized and standardized nutritional treatment mode which brings great challenges to the development of special medical food related to cancer. This article reviews the research hotspots progress existing problems development status and nutritional intervention for malnourished patients at home and abroad aiming to provide new ideas for the basic research and clinical application of tumor-related FSMP.
2022 Vol. 9 (6): 827-833 [Abstract] ( 287 ) HTML PDF (1861 KB)  ( 442 )
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