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2023 Vol. 10, No. 1
Published: 2023-02-09
 
1 Cancer and precision nutrition ：the future is now
Song Yun， Xu Xiping
The number of cancer cases and deaths in the world is still increasing year by year which seriously threatens human health and life resulting in a huge disease burden. The trend is particularly acute in China with a large aging population. The prevention and treatment of cancer have been included in the national health policy outline and the national nutrition plan. The occurrence and development of tumors are the result of the interaction of genetic factors and environmental factors. Emerging evidence has been proven that nutrition plays an important role in the prevention and treatment of cancer. The development direction of precision nutrition is to abandon the " one -size -fits -all" nutrition approach and divide the population into different subgroups according to lifestyle dietary and environmental exposure genetics microbiology metabolomic and biomarkers so as to form more scientific and reasonable dietary recommendations or nutritional intervention strategies. The occurrence and development of tumors are often accompanied by nutritional imbalance and metabolic disorder. Therefore this review focuses on the relationship between tumor and nutrition and discusses the research progress and development direction of tumor and nutrition metabolomic including one-carbon metabolism and folate-regulated metabolism . In the future we hope to establish comprehensive life-cycle management standards and guidelines for cancer and precision nutrition that are more suitable for the Chinese population and ultimately reduce the incidence and disease burden of cancer improve the health level and enhance the quality of life and treatment outcome of cancer patients.
2023 Vol. 10 (1): 1-5 [Abstract] ( 382 ) HTML PDF (827 KB)  ( 554 )
6 Exercise therapy the future of cancer patients with cachexia
Liu Jie,Lu Zongliang,Xu Hongxia
The morbidity and the mortality of cachexia in cancer patients is high and it is difficult to reverse once entering the period of cachexia in clinical. There is no routine intervention for cachexia presently. Therefore it is suggested to pay attention to take a proactive approach in the early stage of the disease to maintain or slow down the loss of function. The benefits of exercise on health have become more and more clearly. Exercise can reduce the risk of malignant tumor reduce the risk of metastasis and recurrence improve the quality of life of cancer patients and possibly improve their survival outcomes. However the best evidence for the feasibility and effectiveness of exercise on muscle and / or weight recovery is mostly found in patients with non cachexia. There are few studies on the role of exercise in cancer cachexia and its role is still uncertain. The combination of exercise nutrition supplement and non-steroidal anti-inflammatory drugs is still the preferred treatment method for multimodal intervention but its benefits in preventing or reversing muscle and / or weight loss need to be further confirmed by more clinical and basic studies. For cachexia patients individualized exercise prescription should be made on the basis of full consideration of safety though the guidelines recommend that cancer patients should exercise. This paper will focus on the application of exercise in cancer cachexia combined with the latest progress of animal model research and clinical application study and explore the application and prospect of exercise therapy in cancer cachexia.
2023 Vol. 10 (1): 6-15 [Abstract] ( 285 ) HTML PDF (931 KB)  ( 351 )
16 Gene polymorphisms in one-carbon metabolism pathway and cancer susceptibility
1He Qiangqiang,2Ding Chengzhi,2Song Jingchao
The high incidence and mortality of cancer threaten human health and lifespan. One-carbon metabolism is one of the important metabolic pathways involved in tumor pathogenesis. The effects of folate and homocysteine two key components of the one-carbon metabolism pathway have attracted the attentions of a large number of studies. Meanwhile multiple functional gene polymorphisms in the one-carbon metabolism pathway also play roles in carriers' susceptibility to cancers but this relationship is often modified by many confounders including nutrients in the one-carbon metabolism pathway. In addition other studies proved these gene polymorphisms are determinants of the sensitivity and toxicity to chemotherapy drugs thus genotype information may provide a basis for the selection and dose setting of clinical chemotherapy drugs. Some studies have found that these functional gene polymorphisms have potential value as prognostic predictors of cancer patients. In this review the research on these aspects is summarized. Nowadays "precision medicine and personalized treatment" has become an important trend in medical development studies on functional gene polymorphism in the one-carbon metabolism pathway may provide an opportunity with great scientific significance and potential value in individualized tumor prevention and clinical treatment.
2023 Vol. 10 (1): 16-21 [Abstract] ( 262 ) HTML PDF (1763 KB)  ( 172 )
22 The relationship between one-carbon metabolism related nutrient and cancer
1Zhou Ziyi，2Liu Demei，2Xu Ping
Metabolic disorders are considered to be a fundamental feature of all cancer cells and genes related to the regulation of cellular metabolism have gradually become targets for cancer diagnosis and treatment. One-carbon metabolism is a prevalent metabolic process in cells mainly responsible for body biosynthesis amino acid homeostasis epigenetic maintenance and regulation of cellular nutritional status etc. Its important metabolic pathways folate cycle and methionine cycle are closely related to the prevention and development of tumors. The core of the folate cycle is the interconversion of folate and its derivatives which on the one hand has been shown to be effective in reducing the risk of cancer development while on the other hand if precancerous lesions have already formed the DNA precursors provided by the folate cycle may provide raw material for cancer cell growth thus accelerating the development of cancer. In addition abnormal activation of the serine biosynthetic pathway in this cycle is one of the important processes in cancer pathogenesis. The enzymes required in its metabolic process have been found to be closely related to cancer and are expected to be key targets for tumor prevention and treatment. Various coenzymes are also involved in this cycle such as vitamin B12 and vitamin B6 which are closely associated with cancer progression. Methyl donors play a pivotal role in epigenetic and metabolic pathways and are considered to be one of the most promising targets for the prevention and treatment of cancer. In the methionine cycle pathway elevated levels of S-adenosylmethionine and deficiencies of choline and betaine all affect DNA methylation thereby increasing cancer risk. This study will briefly review the relationship between one-carbon metabolism and cancer and elucidate the role of one-carbon metabolic indicators on cancer prevention and development.
2023 Vol. 10 (1): 22-28 [Abstract] ( 275 ) HTML PDF (2348 KB)  ( 559 )
29 Vitamin D and risk of cancer a systematic review
1Wei Yaping,2Zhu Zhaoping,2Wang Bei
Cancer is a major public health problem worldwide which seriously threatens the life and health of humans. A large body of epidemiological evidence supports a role for vitamin D in the protection of cancer risk. The antitumor effect of vitamin D mainly comes from the binding of its active metabolites to receptors to perform related biological functions but the relationship varies depending on the location of the tumor. Meta-analysis has generally reported high vitamin D status is a protective factor for breast colorectal liver bladder and lung cancers OR= 0. 46-0. 92 . In addition the association of vitamin D-related gene polymorphisms with cancer and its impact on the relationship between vitamin D levels and the risk of cancer has also attracted great attention. Single nucleotide polymorphisms in vitamin D receptors and vitamin D synthesis and degradation pathways are associated with the risk of tumor development and progression. This article reviews the research progress of vitamin D metabolism its potential anti - cancer mechanisms and its relationship with the risk of different cancers and explores the relationship between vitamin D- related gene polymorphisms and different cancers so as to provide a theoretical basis for the primary prevention of cancer in the future.
2023 Vol. 10 (1): 29-36 [Abstract] ( 220 ) HTML PDF (1584 KB)  ( 583 )
37 Comparison and analysis of current trends of breast cancer in China and the United States
1Li Shuqun,2Zhang Yan,2Dang Qi
The incidence of breast cancer has shown a staggering trend in different regions globally. In terms of the rate of increase in incidence and mortality developing countries represented by China show an increasing trend while in highly developed countries like the United States there is an overall decreasing trend. We aim to illustrate the difference in incidence mortality survival rate and treatment between China and the United States through a systematical comparison and analysis. The results show that China has lower mortality in breast cancer than the United States though a higher proportion of the global incidence. China is far from a standard breast cancer screening procedure which leads to a ten-year delay in diagnosis of breast cancer in Chinese women than in American women accompanied by the advanced stage of cancer and larger tumor sizes. Chinese women are diagnosed at a more advanced stage and with larger tumors. This determines the different tendencies of the two countries regarding the prevention and treatment of breast cancer. In conclusion the successful experience of dealing with breast cancer in America shed a light on China to escape from the health public burden resulted from the occurring new cases.
2023 Vol. 10 (1): 37-41 [Abstract] ( 235 ) HTML PDF (1245 KB)  ( 667 )
42 AllergoOncology position papers interpretation
1,2Chen Lijia,1Wang Hongtian,2Wang Xueyan
AllergoOncology is a combination of allergy and oncology. The relationship between allergy and tumor has been discussed and studied decades ago. In the 1960s a negative correlation between allergy and tumor morbidity was first discovered. Since then there has been an endless stream of related researches on basic translational and clinical medicine in this field. In 2014 a Task Force on AllergoOncology was established at the European Association of Allergy and Clinical Immunology EAACI led by Professor Erika Jensen-Jarolim aiming to establish a routine platform for allergy oncology achievements. Focusing on the intersection of allergy and oncology the working group is dedicated to research on immune surveillance immune regulation and IgE-mediated tumor immune responses and has issued 5 position papers on AllergoOncology. It has promoted the transformation of the core theory of allergy into clinical practical cancer treatment and is expected to further improve the therapeutic efficacy efficacy of tumors. This article interprets the position papers of AllergoOncology from the negative correlation between allergy and tumor effectors cells and molecules and microbiota in allergy and cancer and translational strategies in AllergoOncology based on novel insights into the field of AllergoOncology.
2023 Vol. 10 (1): 42-49 [Abstract] ( 211 ) HTML PDF (2508 KB)  ( 204 )
50 Potential application of postbiotics in prevention and treatment of colorectal cancer
1Ding Chao,2Chen Mingfei,1Wang Hao
Postbiotics refer to preparation of inanimate microorganisms and / or their components that confers a health benefit on the host mainly including the components of the microorganism itself such as cell wall cellular peptides and microbial metabolites. Postbiotics have the advantages of fixed chemical structure safe and non - toxic properties due to inactivated microorganisms and longer shelf life compared to probiotics prebiotics and synbiotic products. In recent years the incidence of colorectal cancer has increased rapidly and the relationship between colorectal cancer and gut microbiota has been more studied. Gut microorganisms interact with host cells in healthy intestines modulating energy acquisition metabolism and immune response. Dysbiosis occurs when microbiota is disturbed by environment invasion of pathogenic microorganisms and other factors stimulating occurrence and development of colorectal cancer. Studies have confirmed that some postbiotics such as short chain fatty acids exopolysaccharides and tryptophan metabolites can exhibit anticancer activity through different mechanisms providing a new vision for the prevention and treatment of colorectal cancer but the specific clinical feasibility and treatment strategies still need to be further explored. This review focuses on the definition classification mechanism of postbiotics and its connection with colorectal cancer along with the latest research progress at home and abroad providing a theoretical basis for the application in the prevention and treatment of colorectal cancer.
2023 Vol. 10 (1): 50-56 [Abstract] ( 256 ) HTML PDF (919 KB)  ( 441 )
57 Expert consensus on anti-inflammatory diet for cancer prevention
Chinese Society of Nutritional Oncolog Community Nutrition and Health Management Branch of Chinese Nutrition Society Clinical
Tumor is a kind of malignant wasting disease which seriously threatens human life and health. Its incidence and mortality are increasing year by year. There are complex factors affecting the occurrence and development of tumors among which diet is the main preventable factor and its potential role cannot be ignored. Diet has both pro - inflammatory and anti - inflammatory properties. Long-term chronic inflammation caused by irrational diet is closely related to tumor and reduces the therapeutic effect of tumor. Scientific and reasonable diet can improve the chronic inflammation state of the body change the tumor microenvironment so as to achieve the role of preventing tumor occurrence and promoting the recovery of patients. It is of positive significance for scientific research and clinical prevention and treatment to objectively evaluate the inflammatory effect of diet on the body. Dietary inflammation index DII is a new method to evaluate individual dietary inflammatory potential which is objective convenient and reproducible. In recent years many studies have explored the relationship between DII and various tumors. This consensus using DII as the research tool summarizes the relationship between pro - inflammatory diet and the incidence of various types of tumors and proposes an anti-inflammatory dietary model for cancer prevention and treatment so as to provide prevention and adjuvant treatment strategies for cancer patients from the perspective of anti-inflammatory diet. To promote scientific and healthy eating behavior encourage residents to adjust the dietary structure and provide a new strategy for nutritional treatment of cancer patients.
2023 Vol. 10 (1): 57-63 [Abstract] ( 1206 ) HTML PDF (905 KB)  ( 2038 )
64 Updated guideline for oral nutritional supplements
Chinese Society of Nutritional Oncology
The incidence of malnutrition in tumor patients is high. As a first-line treatment nutritional therapy is very necessary for tumor patients which should be run through the whole treatment cycle. Oral nutritional supplements as one of the important means of enteral nutrition in artificial nutrition is widely used in clinical practice with still many details of clinical use unclear. Based on the 2018 and later-on ESPEN ASPEN and CSPEN nutrition guidelines this paper searches the pubmed CAJD and Wanfang data from January 1st 2017 to October 31st 2022 for randomized controlled clinical trials expert consensus Meta - analysis and systematic. The search free words are " oral nutrition supplement" " nutrition treatment" " nutrition intervention" " enteral nutrition treatment" and "formula food for special medical purposes". The authors carried out literature reading according to the search results and expanded the search to the references. This paper updated the detailed evidence reporting patients with different tumor pathological types who can benefit from the use of ONS especially the method the dosage of ONS as well as the appropriate formula for different tumor and additional immune enhancing nutrients. The authors used GRADE method to evaluate the evidence so as to provide a theoretical basis for further clinical practice for oral nutritional supplements.
2023 Vol. 10 (1): 64-68 [Abstract] ( 481 ) HTML PDF (1656 KB)  ( 779 )
69 Effect of miR-221-5p on biological behavior of gastric cancer cells by targeting regulation of ALDH1A2
1Yang Taoyong,2Qian Kun,1Zhu Dan,1Jiang Xianxue
Objective To investigate the targeting relationship between miR-221-5p and aldehyde dehydrogenase-1 family member A2 ALDH1A2 and its effect on proliferation migration invasion and epithelial-mesenchymal transformation EMT of gastric cancer cells. Method Gastric cancer tissues and their adjacent normal tissues were obtained from 50 patients with gastric cancer by radical gastrectomy in Yuechi People's Hospital from July 2020 to July 2022. The cell lines cultured in vitro included human normal gastric mucosal epithelial cell line GES-1 and human gastric cancer cell lines BGC-803 AGS SGC-7901 BGC-823 and HGC-27. The expression of miR- 221- 5p and ALDH1A2 mRNA in tissues and cells was detected by qRT-PCR. The correlation between miR- 221-5p expression and clinicopathological parameters in gastric cancer was analyzed by Pearson test. The targeting regulation of miR-221-5p on ALDH1A2 was verified by bioinformatics prediction and dual luciferase experiment. HGC-27 cells were divided into control group inhibitor-NC group miR- 221 - 5p inhibitor group mimic NC group miR- 221 - 5p mimic group miR- 221 - 5p mimic + pcDNA3. 1 group and miR - 221 - 5p mimic + pcDNA3. 1 - ALDH1A2 group and the corresponding plasmids were transfected. Cell proliferation invasion migration apoptosis and cell cycle distribution were detected by MTT method clone formation test Transwell chamber test scratch test and flow cytometry respectively. The expression of EMT-related proteins in cells was analyzed by Western blot. Result The expression of miR-221-5p was significantly high in gastric cancer tissues and cells while the expression of ALDH1A2 mRNA was significantly down-regulated in gastric cancer tissues P< 0. 05 . The expression of miR- ·69· 肿瘤代谢与营养电子杂志 2023 年 2 月 9 日第 10 卷第 1 期 Electron J Metab Nutr Cancer, Feb. 9, 2023, Vol. 10, No. 1 221-5p was significantly correlated with TNM stage tumor differentiation and lymph node metastasis in patients with gastric cancer P<0. 05 . MiR-221-5p targeted inhibition of ALDH1A2 expression. Compared with anti-miR-NC group the OD value scratch healing rate E-cadherin α-catenin protein expression and the proportion of S phase cells in anti-miR-221-5p group decreased significantly while the expression level of E- cadherin and α - catenin protein and the proportion of G0 / G1 phase cells increased significantly while the number of monoclonal formation and invasion decreased significantly P<0. 05 . The miR-221-5p group of cells obtained the opposite results as described above when compared to the miR-NC group. Up-regulation of ALDH1A2 expression can reverse the effect of miR-221-5p on the malignant biological behavior of HGC-27 cells. Conclusion Overexpression of miR-221-5p may promote proliferation migration invasion EMT and cell cycle progression and inhibit apoptosis of gastric cancer cells through targeted down-regulation of ALDH1A2 expression.
2023 Vol. 10 (1): 69-79 [Abstract] ( 170 ) HTML PDF (20166 KB)  ( 24 )
80 The prognostic value of preoperative neutrophil - lymphocyte ratio in patients with concurrent colorectal cancer and liver metastasis
1Yang Cheng,1Nie Shuangfa,1 Wu Liang，1Wu Xueliang,1Fei Jiandong,2Zhang Jianfeng
Objective To investigate the prognostic value of preoperative neutrophil - to - lymphocyte ratio NLR and carcinoembryonic antigen CEA in patients with concurrent colorectal cancer liver metastases. Method The clinicopathological data of patients with concurrent colorectal cancer liver metastases who underwent liver resection in our hospital from August 2012 to December 2017 were retrospectively analyzed and X-TILE software was used to calculate the best cut-off value of NLR. Kaplan-Meier method and Log-rank test were used to draw and compare different survival curves and COX proportional hazards regression model was used to analyze independent prognostic factors. The time dependent area under ROC curve t - AUC is used to draw and compare the prognostic value of different indicators also in combination. Result A total of 122 patients with concurrent liver metastases from colorectal cancer were included in this study. After calculation the best cut-off value for NLR for prognostic stratification is 2. 1. The preoperative higher NLR was correlated with higher pathological T staging P= 0. 037 but compared with the low NLR group there was no significant difference in other indicators all P > 0. 05 . Univariate survival analysis showed that preoperative NLR level maximum liver metastasis diameter colorectal cancer pT stage lymph node metastasis and preoperative CEA level were correlated with the prognosis of patients with concurrent colorectal cancer liver metastasis all P<0. 05 multivariate Survival analysis the number of liver metastases HR= 1. 644 95%CI = 1. 063-2. 542 P= 0. 025 lymph node metastases HR= 1. 76 95%CI = 1. 045-2. 965 P = 0. 034 CEA≥3. 4 μg / L HR= 1. 611 95%CI = 1. 054-2. 460 P= 0. 028 and NLR≥2. 1 HR= 1. 625 95%CI = 1. 044-2. 539 P= 0. 033 are the prognosis of patients with liver metastases from concurrent colorectal cancer Independent risk factors. When NLR ·80· 肿瘤代谢与营养电子杂志 2023 年 2 月 9 日第 10 卷第 1 期 Electron J Metab Nutr Cancer, Feb. 9, 2023, Vol. 10, No. 1 predicts patient prognosis t-AUC is 60. 89% ~ 66. 41% CEA is 58. 15%-66. 41% and t-AUC is 64. 53%-68. 36% when the two indicates are combined. In addition the C-index of CEA in predicting the prognosis of patients was 0. 648 95%CI = 0. 543-0. 752 and the NLR was 0. 688 95%CI = 0. 583-0. 795 . There was no significant difference between the two indicates P = 0. 29 . When combination CEA and NLR to predict the prognosis the C-index could be increased to 0. 69 95%CI = 0. 586-0. 795 . However there was no statistical difference when compared with CEA P = 0. 12 or NLR P = 0. 52 alone respectively. Conclusion The elevate of preoperative NLR or CEA is closely related to the poor prognosis of patients with concurrent colorectal cancer liver metastases. The combined use of preoperative NLR and CEA can improve the accuracy of predicting the prognosis of patients.
2023 Vol. 10 (1): 80-86 [Abstract] ( 143 ) HTML PDF (1789 KB)  ( 147 )
87 Construction of evidence-based clinical management sensitive indicators for cancer nutrition
1Zhang Ting,2Yang Qing,3Yan Hongyan,2Jiang Qinghua,4Wang Guorong,5Tang Xiaoli
Objective To construct a scientific and objective clinical management sensitive indicators for cancer nutrition in order to provide references for evaluating and monitoring the quality of care in cancer nutrition therapy. Method The structure-processoutcome model was used as the theoretical framework. Constructing a search strategy and searching for evidence. Literature screening and data extraction were conducted according to the inclusion and exclusion criteria by two researchers independently. Level of evidence and methodological quality were evaluated using relevant tools. The preliminary draft of clinical management sensitive indicators for cancer nutrition was formed based on evidence. 14 experts from 9 grade A tertiary hospitals in Beijing Shanghai Guangzhou Chongqing and Sichuan in China was consulted by Delphi method. To test the reliability and representativeness of expert consultation indicators such as expert positive coefficient authority coefficient variation coefficient and coordination coefficient were used. The analytic hierarchy process was used to determine the weight of indicators at all levels. Result The effective recovery rates of the 2 rounds of expert consultations were 100% and 92. 8% respectively. In the two rounds the expert authority coefficients were 0. 946 and 0. 979 the coefficients of variation were 0. 135 and 0. 084 and the Kendall harmony coefficients were 0. 241 P<0. 01 and 0. 284 P<0. 01 respectively. The final sensitive indicators included 7 structural indicators 20 process indicators and 4 outcome indicators. Conclusion The clinical management sensitive indicators for cancer nutrition is scientific and reliable which was helpful to improving the clinical quality in cancer nutrition.
2023 Vol. 10 (1): 87-94 [Abstract] ( 197 ) HTML PDF (960 KB)  ( 222 )
95 Risk factors of sarcopenia in patients with gastric cancer
He Yongjing， Wei Haobin， Liu Weiwei， Pan Li， Wang Yu， Li Suyi
Objective To explore the correlation between sarcopenia and tumor clinical stage characteristics adverse reactions after chemotherapy and peripheral blood inflammatory indexes. Moreover the correlation between appendicular skeletal mass index ASMI and the patient-generated subjective global assessment PG-SGA for the assessment of patient nutritional status were also be analyzed. Method The clinical data of 125 patients with advanced gastric cancer in the First Affiliated Hospital of University of Science and Technology of China Western District from January 2019 to February 2022 were collected. Pearson analysis was carried out to analyze the correlation between ASMI and PG-SGA score. Result Among the 125 patients the incidence of sarcopenia was 43. 2% 54 of 123 patients . The sarcopenia group was significantly older and the incidence of grade Ⅲ/ Ⅳ adverse reactions after chemotherapy was higher In addition the sarcopenia group showed lower BMI but higher PG-SGA score and NLR neutrophil-to-lymphocyte ratio NLR P <0. 05 . Univariate analysis and multivariate analysis showed that age PG-SGA score grade Ⅲ/ Ⅳ adverse reaction after chemotherapy and NLR were independent risk factors for sarcopenia P < 0. 05 . There was a significant negative correlation between ASMI and PG-SGA score r = - 0. 38 P < 0. 001 . Conclusion Advanced age the occurrence of adverse reactions after chemotherapy and the systemic inflammatory state of patients are closely related to the occurrence of sarcopenia in advanced gastric cancer. ASMI and PG-SGA have a good correlation in the evaluation of nutritional status of patients.
2023 Vol. 10 (1): 95-100 [Abstract] ( 199 ) HTML PDF (864 KB)  ( 174 )
101 Effect of a new enteral nutrition formula strengthened with L-carnitine and taurine on patients with lung cancer undergoing chemotherapy
1Zheng Jing,2Li Jianjun
Objective To explore the effect of a novel enteral nutrition formula fortified with L-carnitine and taurine on patients undergoing chemotherapy for lung cancer to provide clinical practice basis for the development of a novel nutrition formula. Method Lung cancer patients who were admitted to Banan Hospital Affiliated to Chongqing Medical University from May 2021 to June 2022 were screened and randomly divided into two groups. The experimental group was given by a novel enteral nutrition formula supplemented with L-carnitine and taurine and the control group was given by a conventional whole protein enteral nutrition formula. The patients took 50 g of their own formula three times a day for 12 weeks. The quality of their daily life nutritional status and the incidence of toxic and side effects during chemotherapy were compared between the two groups pre- and post- treatment. Result A total of 83 patients were involved in the experimental group and 85 patients were involved in the control group. Before treatment there was no significant statistical difference between the two groups in the scores of quality of life in various fields including body mass index total serum protein albumin hemoglobin and subjective overall nutrition assessment scale P>0. 05 . After treatment the patients in the experimental group obtained higher scores in all fields of quality of life. Especially body mass index total serum protein albumin and hemoglobin were significantly higher than those in the control group. Even the lower all subjective nutrition assessment scale score was the better nutritional status is. The difference was statistically significant P<0. 05 . The grade of leukocyte toxicity and side effects in the experimental group were lower than those in the control group the gastrointestinal reaction was smaller and the duration of malignant vomiting was shorter than that in the control group. The difference was statistically significant P<0. 05 . Conclusion The novel enteral nutrition formula strengthened with L-carnitine and taurine can be applied to lung cancer chemotherapy patients which is conducive to improving their quality of life and their nutritional status and reducing the toxic and side effects of chemotherapy.
2023 Vol. 10 (1): 101-106 [Abstract] ( 303 ) HTML PDF (859 KB)  ( 226 )
107 Relationship between fat-free mass index and perioperative outcomes in esophageal cancer patients
Xia Qianqian, Wang Wei, Chen Haisheng
Objective To explore the effects of fat-free mass index FFMI on postoperative complications and in-hospital mortality and clarify its predictive value for perioperative outcomes of esophageal cancer patients. Method This analysis included 152 esophageal cancer patients who underwent curative esophagectomy at the Department of Thoracic Surgery in Haian Hospital Affiliated to Nantong University from January 2017 to December 2021. The FFMI was measured and calculated by bioelectrical impedance analysis and then all patients were divided into low FFMI 103 and normal FFMI 49 group based on the cutoff value of FFMI male <17 kg / m 2 female < 15 kg / m 2 . The baseline characteristics and perioperative outcomes of the two groups were compared. In addition the Logistic regression model was used for univariate and multivariate analysis to determine the independent risk factors of postoperative complications for esophageal cancer patients. Result Except for body mass index there were no significant differences between low FFMI and normal FFMI group for age gender comorbidities clinicopathological features and laboratory tests P>0. 05 . The baseline characteristics between the two patient groups were comparable. Compared with the normal FFMI group low FFMI group had a higher rate of postoperative complications 40. 8% vs 21. 4% χ 2 = 6. 286 P = 0. 012 especially anastomotic leakage 40. 8% vs 21. 4% χ 2 = 5. 191 P= 0. 032 and pneumonia 28. 6% vs 12. 6% χ 2 = 5. 783 P = 0. 016 . In addition the length of hospital stays was longer in low FFMI group than in the normal FFMI group IQR 14. 0 12. 0 18. 0 d vs 12. 0 11. 0 16. 0 d Z = - 1. 985 P = 0. 047 . However there was no significant difference between the two groups for postoperative in-hospital mortality 4. 1% vs 1. 9% χ 2 = 0. 593 P= 0. 388 . The results of univariate and multivariate logistic regression analysis revealed that preoperative FFMI OR = 2. 502 95%CI = 1. 181 - 5. 301 P = 0. 017 and hypoalbuminemia OR = 2. 570 95% CI = 1. 115 - 5. 926 P = 0. 027 were independent risk factors of postoperative complications for esophageal cancer patients who underwent curative esophagectomy. Conclusion FFMI was an effective parameter to predict the perioperative outcome and this finding further emphasized the value of body composition measurement in the clinical management of esophageal cancer patients.
2023 Vol. 10 (1): 107-112 [Abstract] ( 160 ) HTML PDF (855 KB)  ( 232 )
113 Application of GLIM criteria in diagnosis of malnutrition in patients with gastrointestinal malignancy
1Rui Hongxia,1Zhang Dongting,2Zhang Xiaoyu,1Yu Huilin,1Yang Tingting,1Zhou Bo
Objective To investigate the occurrence of malnutrition in patients with gastrointestinal malignancy according to the Global Leadership Initiative on Malnutrition criteria GLIM and compare the consistency of GLIM and patient-generated subjective global assessment PG- SGA in the diagnosis of malnutrition. Method A total of 220 patients with gastrointestinal malignancies admitted to the First Affiliated Hospital of Anhui Medical University were selected from October 2021 to July 2022 for nutritional assessment using the GLIM criteria and PG-SGA. Patients' body composition was measured by bioelectrical impedance technology and Kappa consistency test was used to analyze the consistency of GLIM and PG-SGA evaluation results. Result 112 patients 50. 9% were diagnosed as malnutrition by GLIM including 85 moderate and 27 severe malnutrition. The severity of malnutrition was significantly different in age weight body mass index right upper arm circumference right calf circumference hand grip strength fat mass fat mass percentage fat free mass fat free mass index muscle and skeletal muscle P < 0. 05 . One hundred and 58 patients 71. 8% were diagnosed as malnutrition by PG-SGA including 85 moderate and 73 severe malnutrition. GLIM and PG-SGA had good consistency in the diagnosis of malnutrition Kappa = 0. 548 P < 0. 001 and the area under the ROC curve was 0. 821 95% CI = 0. 745-0. 877 . When distinguishing patients with different degrees of malnutrition the level of consistency was relatively low Kappa = 0. 344 P<0. 001 . Conclusion GLIM criteria and PG-SGA have a good consistency in the diagnosis of malnutrition but a relatively poor consistency in the classification of the severity of malnutrition. However this does not affect the clinical applicability of GLIM criteria.
2023 Vol. 10 (1): 113-119 [Abstract] ( 245 ) HTML PDF (1136 KB)  ( 270 )
120 Relationship between nutritional risk screening 2002 and unplanned hospital readmission within 30 days after curative gastrectomy for gastric cancer
Wang Xuan,Wu Xiancui, Zhang Yunxia, Zhang Jing
Objective To investigate the incidence and risk factors for unplanned hospital readmission within 30 days in gastric cancer patients who underwent curative gastrectomy and clarify the predictive value of nutritional risk screening 2002 NRS 2002 tool for unplanned readmission. Method This retrospective analysis included 312 patients who underwent curative gastrectomy for gastric cancer in Nanjing Hospital Affiliated to Nanjing Medical University between January 2016 and January 2022. The incidence and causes of unplanned readmission after curative gastrectomy for gastric cancer were analyzed. All patients were divided into readmission 26 and non-readmission 286 group and the distribution of baseline characteristics between the two groups was compared. The univariate and multivariate logistic regression analysis was conducted to identify the independent risk factors for unplanned readmission. Result According to the NRS 2002 scale 33. 0% 103 / 312 of gastric cancer patients were at risk of preoperative malnutrition NRS 2002 score ≥ 3 points . The unplanned readmission rate within 30 days was 8. 3% 26 / 312 for gastric cancer patients who underwent curative gastrectomy and the average time interval from discharge to readmission was 10. 8 ± 7. 4 days. Postoperative ileus 19. 2% 5 / 26 and intra-abdominal fluid collection / infection 15. 4% 4 / 26 were the main causes of hospital readmission. The univariate and multivariate logistic regression analysis demonstrated that NRS 2002 score ≥ 3 points OR = 3. 259 95% CI = 1. 357-7. 828 P= 0. 008 patient age ≥ 65 years OR= 3. 212 95%CI = 1. 256-8. 213 P= 0. 015 the presence of postoperative complications OR= 3. 407 95%CI = 1. 258-9. 226 P = 0. 016 and operation time ≥ 180 min OR= 2. 734 95%CI = 1. 108-6. 746 P= 0. 029 were independent risk factors for unplanned readmission in gastric cancer patients who underwent curative gastrectomy. Conclusion The NRS 2002 was an effective tool to predict unplanned readmission after curative gastrectomy for gastric cancer. This finding further emphasized the importance of optimizing preoperative nutritional status to improve the adverse perioperative outcomes.
2023 Vol. 10 (1): 120-126 [Abstract] ( 147 ) HTML PDF (871 KB)  ( 223 )
127 Applications of mini nutritional assessment short form and global leadership initiative on malnutrition criteria in nutritional assessment among elderly inpatients with chronic obstructive pulmonary disease
Jin Yanxin,Gong Shaoxia, Liu Tianjin, Chen Jie, Gao Yanling
Objective To compare the consistency of mini nutritional assessment short form MNA- SF and global leadership initiative on malnutrition GLIM criteria in nutritional assessment among elderly inpatients with chronic obstructive pulmonary disease COPD . Method From January 2020 to December 2021 489 elderly COPD inpatients were randomly selected from the second peoples' hospital of Yibin to assess the nutritional status by MNA-SF and GLIM criteria respectively and to analyze the consistency of two methods. Result 172 35. 17% 228 46. 63% and 89 18. 20% patients were diagnosed good nutrition malnutrition risk and malnutrition by MNA - SF respectively. There were significant differences in MNA - SF scores and malnutrition incidence among different age groups whether combined chronic diseases and course of disease P<0. 05 . The incidence of nutrition risk screening by nutritional risk screening 2002 NRS 2002 was 50. 31% and the incidence of malnutrition diagnosed by GLIM was 28. 83%. The incidence of nutrition risk and malnutrition in <70 years old group was higher than that in ≥70 years old group. The incidence of nutrition risk and malnutrition in the group with chronic disease was higher than that in the group without chronic disease. The longer the course of disease the higher the nutrition risk and malnutrition incidence P<0. 05 . The Kappa value of malnutrition diagnosed by MNA-SF and GLIM was 0. 675 and the Kappa value of nutrition risk diagnosed by NRS 2002 and MNA-SF was 0. 619 while the Kappa value of malnutrition severity level diagnosed by MNA-SF and GLIM was 0. 348 P<0. 05 . Conclusion The nutritional risk and malnutrition rate are high among elderly COPD inpatients. MNA-SF and GLIM criteria can be used to diagnose malnutrition in elderly COPD inpatients.
2023 Vol. 10 (1): 127-132 [Abstract] ( 148 ) HTML PDF (849 KB)  ( 243 )
133 Critical weight loss among nasopharyngeal carcinoma patients undergoing intensity-modulated radiation therapy influencing factors analysis and prediction model establishment
1,2Chen Liping,2Xia Le,1Shi Lei
Objective To analyze the influencing factors of critical weight loss among patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy IMRT and establish a prediction model. Method The general demographic data clinical characteristics and nutritional status of 377 patients with nasopharyngeal carcinoma NPC patients undergoing IMRT were prospectively collected. Taking weight loss ≥10% as the criteria for judging critical weight loss patients were divided into critical weight loss CWL group 154 cases and non-critical weight loss Non-CWL group 233 cases . Univariate analysis was performed first to select significant variables for multiple factor logistic regression analysis. And a prediction model was constructed based on the analysis results. Then use the area under the receiver operating characteristic ROC curve and the Hosmer-Lemeshow fit curve to evaluate the effectiveness and discrimination of the model. Result Among 377 nasopharyngeal carcinoma patients 154 patients were divided into CWL group. Univariate analysis showed that family history of tumor combined cardiovascular and cerebrovascular diseases N stage UICC the IMRT dose of neck BMI use of chemotherapy during radiotherapy use of targeted drugs during radiotherapy Epstein-Barr EB virus DNA copy number and working conditions were significant differences between two groups P< 0. 10 . The multivariate Logistic regression showed that no family history of tumor high N stage UICC high IMRT dose of neck high BMI use of chemotherapy during radiotherapy and no use of targeted drugs during radiotherapy were independent risk factors for CWL P<0. 05 . According to the results of multivariate Logistic regression analysis a prediction model for CWL in NPC patients undergoing IMRT was constructed and evaluated. The area under the ROC curve was 72. 5% the sensitivity was 73. 9% and the specificity was 57. 8% . The H - L fit curve results showed that P = 0. 25 suggested that the model has good fitting effect and discrimination efficiency. Conclusion The constructed prediction model has good predictive value and can be used as a tool to screen the risk of CWL in nasopharyngeal carcinoma patients undergoing IMRT. The model provides reference for clinical medical staff to ·133· 肿瘤代谢与营养电子杂志 2023 年 2 月 9 日第 10 卷第 1 期 Electron J Metab Nutr Cancer, Feb. 9, 2023, Vol. 10, No. 1 timely and targeted preventive nutritional support for high CWL risk patients with nasopharyngeal carcinoma during radiotherapy.
2023 Vol. 10 (1): 133-139 [Abstract] ( 319 ) HTML PDF (1150 KB)  ( 224 )
140 Cannabidiol in tumor therapy
1Zhou Ruiyi,1Wu Xiaocong,2Lei Yi,1Sun Jiaxue,1，2Xu Yu,1，3Wang Kunhua
Cannabidiol CBD is the main component of cannabis extract which is a non - psychoactive substance with non - addictive low toxicity and high safety. CBD has shown unique advantages in tumor therapy and is being used on refractory epilepsy. Its mechanisms include as follows. ① Inducing cell cycle arrest and inhibiting tumor cell proliferation. ② Promoting tumor cell apoptosis through increasing ROS levels in tumor cells inducing mitochondrial dysfunction regulates Bcl-2 family proteins and inhibiting IAP family protein function. ③ Inhibiting tumor cell migration and invasion. ④ In conjunction with other anti - cancer therapies to exert a stronger anti-tumor effect. ⑤Relieve tumor-related symptoms such as pain anxiety and depression. ⑥It may play a role in regulating the tumor microenvironment. CBD has shown good anti - tumor properties in various tumor treatments and is expected to be used as a new tumor treatment drug in clinical practic. At present clinical trials related to CBD and cancer treatment mainly focus on analgesic treatment for patients with advanced tumors and its direct therapeutic effect still needs further clinical trials.
2023 Vol. 10 (1): 140-148 [Abstract] ( 147 ) HTML PDF (960 KB)  ( 76 )
149 The research advance on the interaction between malnutrition and Alzheimer's disease
Jiang Jiwei, Li Wenyi, Jiang Shirui, Wang Linlin, Ren Qiwei, Xu Jun
Alzheimer􀆶 s disease AD an aging - related neurodegenerative disease and the leading cause of dementia in the elderly represents sharply escalating challenge to public health management. The underlying mechanisms of AD are uncertain which causes the optimal strategies to delay or even prevent the disease progression yet to be established. Over the past two decades clinical trials of single-agent drugs targeting amyloid-beta and tau pathologies have frequently failed to cure AD suggesting that as a complex brain disease with multiple causes and pathological mechanisms AD should be paid attention to multi-dimensional prevention and treatment. In recent years gut-microbiota connecting with the central nervous system through bidirectional communication with aging immune and metabolic pathways has become a hot mechanism for AD. As the most direct and extensive environmental factor affecting gut microbiota dietary nutrition can affect AD related cognitive symptoms through behavioural genetic systemic immune metabolic and vascular factors which provides new insights into comprehensive multi - targeted intervention strategies of AD. Despite accumulating knowledge the understanding of nutrition and AD is still insufficient and current research evidence is mostly limited to preliminary small samples and various dementia types. Whether malnutrition is a risk factor/ cause of AD or the result of AD-related cognitive or psychobehavioral symptoms remain unclear. Thus this review summarizes the evidence in the past decade on the cause of malnutrition in AD patients and malnutrition risking the onset and progression of AD emphasizing knowledge gaps and providing direction for clinical diagnosis and treatment of AD and further exploration.
2023 Vol. 10 (1): 149-154 [Abstract] ( 259 ) HTML PDF (3025 KB)  ( 310 )
155 Investigation of mechanisms of phytochemicals to counteract tumor invasion and metastasis a review
1Zhu Jiayu,1Cao Peilian,2Wang Shu'an
Malignant tumors are caused by the malignant growth of cells which seriously endanger human health and threaten life. Most deaths from malignant tumors are caused by tumor invasion and metastasis. Through the invasion-metastasis cascade IMC tumor cells are transferred from the primary focus to distant tissues and successfully colonized. IMC is a complex process involving multiple factors and steps. Multiple signal pathways can promote tumor invasion and metastasis. Phytochemicals have been proved to block tumor invasion and metastasis by inhibiting the formation of these signal pathways. Epithelial mesenchymal transformation EMT in the IMC process will strengthen tumor drug resistance and radiation resistance. Because of the mutual promotion between tumor invasion and metastasis with drug and radiation resistance and the shortcomings of large side effects and poor effects of anti-tumor therapy it is urgent to find safe and effective drugs with anti - tumor invasion and metastasis and radiochemotherapy sensitization effect. Studies have shown that phytochemicals have a variety of biological activities. If they are used alone or in combination with anti-tumor therapy they can inhibit tumor invasion and metastasis reduce the toxicity of anti - tumor therapy and improve the radiochemotherapy sensitivity. The purpose of this article is to review the current status and developments of phytochemicals as an anti signal pathway in inhibiting IMC antitumor invasion and anti-metastasis therapy in recent years in order to provide ideas for future research on anti-tumor invasion and metastasis of phytochemicals.
2023 Vol. 10 (1): 155-160 [Abstract] ( 230 ) HTML PDF (1522 KB)  ( 394 )
161 Design and application of clinical nutrition prescription management system
Luo Bin, Wang Wentao, Wang Ying, Xie Ying, Du Hongzhen, Li Zengning
Clinical nutrition prescription is a direct reflection of clinical nutrition treatment strategy. However there is a lack of standardized management of nutrition prescription and informationized management of prescription and a lack of management system of nutrition risk screening nutrition assessment nutrition treatment nutrition monitoring and nutrition follow-up. In order to realize the informationization and standardization of clinical nutrition department work effectively implement nutrition treatment plan improve the effect of nutrition prescription intervention and help patients' clinical recovery it is of great positive significance to develop a convenient and efficient nutrition prescription management system for clinical nutrition physicians to manage prescriptions. In the past nutrition treatment process the lack of advanced clinical nutrition treatment support system has become an important influence factor limiting the quality of clinical nutrition services. In order to improve the ability of health and health convenient services optimize the medical treatment environment and enhance the hospital management the standardized management of nutrition prescription is an important work of the hospital clinical nutrition department and it is also one of the important improvement measures to improve the quality of hospital medical services and economic benefits. This system has been online since March 2020 and as of June 2021 4474 nutrition prescriptions have been developed with high application accessibility. The development of the nutrition prescription management system not only provides dynamic data records for clinical nutrition physicians to develop nutrition treatment plans but also improves the efficiency of clinical nutrition physicians and is a strong guarantee for the accuracy and safety of enteral nutrition prescription application.
2023 Vol. 10 (1): 161-165 [Abstract] ( 243 ) HTML PDF (2977 KB)  ( 343 )
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