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2023 Vol. 10, No. 3
Published: 2023-06-09
 
307 Precise and intensive treatment for high-dose vitamin C in cancers
Wang Xin, Rao Benqiang
High-dose vitamin C HVC therapy is a safe and inexpensive anticancer treatment which could cure cancers by promoting oxidative stress epigenetic modification inhibiting HIF-α and immune regulation. However clinical practice has shown that there is only a "weak" inhibitory effect on cancers in high-dose vitamin C application alone. Moreover the anticancer effect of high-dose vitamin C is closely related to the metabolic phenotype. Cancers with mutations in KRS / BRAF HIF TETs/ IDH/ WT1 and high expression of OMM Cyb5R3 / VDAC1 complex or vitamin C transporters are sensitive to HVC treatment. However high -dose vitamin C had no obvious inhibitory effect on tumors with low KRS / BRAF expression suggesting that high-dose vitamin C should be targeted at tumor metabolic phenotype for precise treatment. On the other hand some preclinical trials have shown that there are some methods could improve the anticancer efficacy such as HVC combined with other kinds of vitamin vitamin C nano-crystallization oncolytic virus programmed death receptor - 1 / programmed death ligand - 1 monoclonal antibody and other immune checkpoint inhibitors radiotherapy cytotoxic drug therapy or traditional Chinese medicine etc. It is suggested that precise intensive therapy is an important research direction of high dose vitamin C therapy for tumor but more clinical evidence is still needed.
2023 Vol. 10 (3): 307-312 [Abstract] ( 595 ) HTML PDF (855 KB)  ( 652 )
313 Research progress of high-dose vitamin C anti-tumor therapy
Liu Miaomiao,Dai Jing, Zhou Fuxiang
High-dose intravenous vitamin C HVC has the advantages of low toxicity and low cost and can be combined with other treatments as an emerging treatment strategy for anti - tumor. Its anti - tumor mechanism is mainly pro - oxidative stress. HVC can produce hydrogen peroxide H2O2 produce hydroxyl radicals OH· by Fenton reaction with Fe 2+ and dehydroascorbic acid DHA reduction to kill tumor cells. It can also affect epigenetic regulation and oxygen regulation through the regulation of enzyme activity by redox-active metal particles. In addition HVC can play a role by enhancing immune function and inhibiting tumor metastasis and invasion. A large number of preclinical have shown that HVC can increase the therapeutic effect and reduce the treatment-related adverse reactions. Kirsten rats arcomaviral oncogene homolog KRAS and v-raf murine sarcoma viral oncogene homolog B1 BRAF mutations ten-eleven translocation TET enzymes etc. may be potential therapeutic targets. At present the clinical studies of HVC combined therapy include colorectal cancer gastric cancer pancreatic cancer lung cancer ovarian cancer hematological tumors etc. confirming that HVC combined therapy is safe and has a certain anti-tumor effect. However most of the current studies are single-center and small-sample studies. In the future large-sample prospective randomized controlled trials are still needed and further explore the anti-tumor mechanism of HVC to screen out treatment-sensitive markers.
2023 Vol. 10 (3): 313-318 [Abstract] ( 474 ) HTML PDF (1578 KB)  ( 581 )
319 Traditional Chinese medicine enhances the role of high-dose vitamin C in treating tumors
Qu Jinxiu,Wang Xin,Rao Benqiang
High-dose vitamin C HVC therapy for tumors is essentially a metabolic modulation that treats tumors by regulating tumor and body metabolic reprogramming through mechanisms such as pro -oxidative stress epigenetic modifications immune and oxygen-sensing modulation. Traditional Chinese medicine TCM has the natural advantage of multi-target and multi-path to regulate the complex metabolic network of the body and tumor. Through treatment based on pattern differentiation and "state-target" treatment it can realize the spatial and temporal synergistic regulation between the body and tumor. Research shows that the original pathogenesis of tumor "deficiency toxicity and stasis" can be analogous to the metabolic disorders of tumor energy flow material flow and drainage flow and HVC treatment for tumor interferes with the pathogenesis of tumor "deficiency toxicity and stasis" at the same time. The anti-tumor Heat - clearing and Detoxifying Blood - activating and Stasis - eliminating and the Body resistance - strengthening and consolidating drugs have regulatory effects on tumor mitochondrial metabolism lipid metabolism and amino acid metabolism respectively and TCM can strengthen the effect of HVC for tumor treatment from multiple perspectives such as pro-oxidative stress induction of ferroptosis and inhibition of mitochondrial respiration. Based on the theory of the metabolic reprogramming of tumor " deficiency toxicity and stasis" and "state - target" treatment based on pattern differentiation this paper interprets the theoretical basis of HVC treatment fortified with TCM for tumors and condenses the possible targets and synergistic treatment protocols of HVC treatment fortified with TCM for tumors providing new ideas for TCM combined with HVC treatment for tumors.
2023 Vol. 10 (3): 319-324 [Abstract] ( 245 ) HTML PDF (6512 KB)  ( 283 )
325 Chinese version of patient-generated subjective global assessment:a potential tool to achieve self-assessment of nutritional status of cancer patients
1Zhang Rui,1Feng Ruike,2Fu Zhenming
Malnutrition is common in cancer patients but there is no international gold standard for assessing nutritional status. Patient-generated subjective global assessment PG-SGA is the most widely used tool to evaluate the nutritional status of tumor patients. Although it has been widely used in China there are still many deficiencies in practice. In our previous study we adjusted the PG-SGA to better adapt to the medical environment in China. After deleted items that more than 50% professionals think it is difficult to be finished items with item-total correlation < 0. 1 the new Chinese PG-SGA CPG-SGA was constructed. The CPG- SGA has better descrimative validity than PG - SGA in that survival difference in patients without malnutrition and mild malnutrition can be detected by CPG-SGA but not PG-SGA. Questions in CPG-SGA require no professional knowledge and may be answered by most patients. We also develop a web-based CPG-SGA questionnaire. It is readily available and convenient to answer by patient themselves. We briefly discussed three commonly used nutrition questionnaires in this review highlighting the possibility to use CPG-SGA as a new standard. We advocate and calls for researches to test and validate the prospect of CPG- SGA in China and abroad. This will undoubtedly have a profound impact on improving the nutritional status of cancer patients in China and even internationally thus enhancing their chances of survival.
2023 Vol. 10 (3): 325-329 [Abstract] ( 451 ) HTML PDF (419 KB)  ( 480 )
330 Exploration of exercise for tumor rehabilitation and prevention
Li Zengning,Lu Xuning,Song Fei
Department of Nutrition First Hospital of Hebei Medical University Key Laboratory of Nutrition and Health Shijiazhuang 050031 Hebei China
2023 Vol. 10 (3): 330-335 [Abstract] ( 250 ) HTML PDF (1224 KB)  ( 474 )
336 Expert consensus on nutritional treatment for patients with gastroparesis
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
Lung cancer is one of the most common tumors. Malnutrition is common in patients with lung cancer which is affected by reduced intake surgery and targeted drugs. They should receive nutritional assessment through Nutritional Risk Screening 2002 and patient -generated subjective global assessment. Not all cancer patients receiving chemotherapy need nutritional therapy and routine use of nutritional therapy is not recommended for lung cancer patients receiving chemotherapy with good nutritional status. Protein synthesis and catabolism are abnormal in tumor patients. For advanced lung cancer patients protein decomposition is greater than synthesis and metabolic stress factors will also increase the protein requirement. The protein requirement of lung cancer patients is recommended to be 1. 2 ~ 2. 0 g / kg·d and the target energy intake is recommended to be 25 ~ 30 kcal / kg·d . Oral nutritional supplement is the preferred nutritional therapy for lung cancer patients suitable for patients who can swallow and have normal gastrointestinal function. For lung cancer patients whose enteral nutrition can meet the normal nutritional requirements routine parenteral nutrition therapy is not recommended. When patients cannot meet their nutritional needs through enteral nutrition e. g. severe radiation esophagitis severe nausea and vomiting supplementary parenteral nutrition or total parenteral nutrition should be selected. Oral glutamine can reduce the incidence and severity of radioactive esophageal mucositis in lung cancer patients. Low sugar and high fat formula can improve blood gas analysis and respiratory function indexes in patients with chronic obstructive pulmonary disease.
2023 Vol. 10 (3): 336-341 [Abstract] ( 627 ) HTML PDF (448 KB)  ( 619 )
342 Expert consensus on nutritional treatment for patients with gastroparesis
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
Gastroparesis is a clinical syndrome caused by gastric emptying disorder with nausea vomiting abdominal distension and abdominal pain as the main manifestations. Gastroparesis has long posed a serious threat to human health with a mortality rate much higher than that of non-gastroparesis patients. Patients with gastroparesis are often accompanied by vomiting early satiety and abdominal distension which lead to insufficient nutrient intake. Nutritional screening and assessment and appropriate nutritional treatment according to the assessment results and conditions are important measures to treat gastroparesis and prevent complications related to gastroparesis. After completing the evaluation of gastroparesis patients it is necessary to formulate a set of individualized nutritional treatment plan which mainly includes the adjustment of dietary habits low-fat low-soluble fiber diet small number of meals if the nutritional requirements of the body cannot be met the number of meals can be increased appropriately. Eat less fiber-rich foods. Jejunal nutrition is the most effective alternative to oral feeding for gastroparesis patients. Pay attention to energy and trace elements iron fat soluble vitamins B vitamins and folic acid etc. supplement. In patients with malignant tumors protein supply can be increased to 1. 5 g / kg·d . In conclusion nutrition therapy is a necessary link and an important strategy in the treatment of gastroparesis patients.
2023 Vol. 10 (3): 342-347 [Abstract] ( 421 ) HTML PDF (1449 KB)  ( 572 )
348 Application study of a nutritional assistant role in nutritional intervention of head and neck cancer sufferers undergoing chemoradiotherapy
1Wang Shu'an,2Feng Qingzhao,3Wang Yi,4Xu Yan,1Chen Xiaotian,5Zhang Nan
Objective To explore the effects of a nutritional assistant nursing-mode in head and neck cancer patients undergoing radiotherapy whose degree of implementation of nutrition programmes and impact on nutrition status and physical and mental health. Method 138 patients with head and neck cancer in Nanjing Drum Tower Hospital from June 2018 to December 2021 were selected and randomly divided into control group n = 72 and observation group n = 66 . The intervention group patients adopted the nursing-mode of a nutritional assistant role. In the control group was treated with routine nursing-mode. All patients received radical concurrent chemoradiotherapy. Then the nutrient intaking nutritional indexes the degree of anxiety and depression as well as quality of life were compared between the two groups. Result The energies of the two groups were decreased while the indexes of intervention group were better at other time points but there was no statistical significance P> 0. 05 . The proteins intakes of the intervention group were better between two groups P<0. 05 . The HADS and KPS scores of the intervention group were better P< 0. 05 . The indexes of serum albumin and weight in the intervention group were better except CRP P< 0. 05 . Conclusion In the treatment of head and neck cancer the nursing-mode of a nutritional assistant role may help to maintain patients' energy as well as protein intaking. In addition it may also alleviate nutritional status and the physical and psychological healthy states.
2023 Vol. 10 (3): 348-353 [Abstract] ( 168 ) HTML PDF (835 KB)  ( 247 )
354 Investigation and analysis of nutritional status of gastric cancer patients and study on biomarkers of cachexia
1Jiang Xunliang,2Wang Jingyuan,1Wang Ke,1Jiang Yu,1Li Jipeng
Objective The nutritional status of gastric cancer patients based on the nutritional risk screening scale NRS 2002 were investigated and analyzed. Based on the results of high - throughput sequencing the biomarker related to cachexia were screened. Method 1134 patients with gastric cancer who were hospitalized in the First Affiliated Hospital of Air Force Military Medical University from December 2016 to December 2018 were selected as the study subjects. The nutritional status of patients was evaluated according to the NRS 2002. The correlation between nutritional status and demographic characteristics disease progression laboratory indicators and outcomes was compared. At the same time the blood of patients with cachexia n = 3 and non-cachexia n = 2 were extracted for full transcriptional genome sequencing and the differentially expressed miRNAs were screened as a predictive biomarker of cachexia in gastric cancer. Result 772 of the 1134 patients were malnourished and accounting for 68. 08% of the total number of patients. The incidence of malnutrition has differences in age smoking and drinking history tumor stage BMI laboratory indicators and short-term adverse outcomes. The incidence of malnutrition in elderly patients ≥60 years old was significantly higher than that in <60 years old non-elderly patients P= 0. 007 . Smoking P<0. 001 and drinking P= 0. 005 have a significant impact on the nutritional status of patients with gastric cancer. The nutritional status of gastric cancer patients worsened with the increase of tumor stage P = 0. 018 . The albumin hemoglobin and BMI of patients with malnutrition were significantly lower than those with good nutritional status while white blood cell count was higher. Multivariate Logistic regression analysis showed that malnutrition was an independent risk factor for poor prognosis in patients with gastric cancer. Furthermore plasma exosomal miR-206 was identified as a biomarker for the early diagnosis of cachexia via whole-gene sequencing to make up for the lack of methods for the early diagnosis of cachexia. Conclusion The incidence of malnutrition in gastric cancer patients is high and the nutritional status of gastric cancer patients is related to age smoking and drinking history tumor stage BMI laboratory indicators and other factors. Malnutrition is an independent risk factor for poor prognosis of gastric cancer patients. Furthermore we identified a novel plasma exosomal biomarker miR-206 for the early diagnosis of cachexia.
2023 Vol. 10 (3): 354-361 [Abstract] ( 188 ) HTML PDF (1503 KB)  ( 329 )
362 Predictive value of sarcopenia in the efficacy of immunotherapy for advanced non-small cell lung cancer
Zhang Luyao, Wang Liyu, Yu Mingyang, Guo Fen, Feng Ying
Objective To investigate the value of sarcopenia in predicting the prognosis of advanced NSCLC patients using PD1 / PD-L1 immune checkpoint inhibitors ICIs and the incidence of immune - related adverse events irAEs . Method A total of 82 eligible patients with advanced NSCLC treated by PD1 / PD-L1 inhibitors in first-line second-line or third-line were enrolled from May 1 2019 to April 30 2022 at the affiliated Suzhou Hospital of Nanjing Medical University. Patients were divided into sarcopenia group and non- sarcopenia group based on SMI. All the follow - up data including skeletal muscle index SMI blood routine examination blood biochemical test and treatment response were collected in the electronic medical record system. Through Kaplan-Meier Cox survival analysis the Mann - Whitney U test the chi square test univariate and multiple Logistic regression analysis and an independent t-test we evaluated the value of sarcopenia in predicting the curative effect of ICI inhibitors for patients with advanced NSCLC. Result The median progression free survival PFS of all 82 enrolled patients was 8. 5 months range 0. 7-40 months 95%CI = 8. 16-11. 47 . The Kaplan-Meier analysis revealed that patients with sarcopenia had a significantly shorter PFS than those without sarcopenia 5. 8 vs 10 months P = 0. 017 . Mann-Whitney U test showed that triglyceride waist circumference nutritional risk screening 2002 NRS 2002 grade and Karnofsky performance score KPS were significantly different between the two groups P= 0. 022 0. 004 0. 009 0. 007 respectively . Patients were grouped according to whether they had an objective response,and it was found by independent t - test. There was a significant difference in ORR between the sarcopenia group and the non - sarcopenia group 5. 56% vs 39. 13% P = 0. 001 . Based on the occurrence of disease remission patients were categorized into a group of complete remission and partial remission referred to as the OR group and a group of stable disease and disease progression referred to as the non-OR group . An independent t-test revealed a significant difference in SMI between the OR group and the non-OR group 50. 24±8. 48 cm 2 / m 2 vs 45. 09±9. 82 cm 2 / m 2 P= 0. 0408 . The incidence of irAEs in the sarcopenia group was higher than the non-sarcopenia group P= 0. 015 . Moreover irAEs were associated with body mass index BMI albumin / globulin ratio A/ G triglyceride waist circumference third-line treatment and sarcopenia among which A/ G and third-line treatment were independent risk factors. Conclusion Sarcopenia can be used as a sensitive indicator to predict the prognosis of patients with advanced NSCLC receiving immunotherapy. It can effectively identify patients with a poor prognosis thus providing more detailed prognosis stratification and effectively guide clinical early intervention.
2023 Vol. 10 (3): 362-369 [Abstract] ( 229 ) HTML PDF (1272 KB)  ( 484 )
370 Longitudinal investigation on nutritional risk and nutritional status of children with malignant tumor during treatment
1Zhao Wenli,1Yan Jie,2Su Yan,1Wang Meichen,1Yang Wenli,2Duan Yanlong
Objective To investigate and evaluate the malnutrition risk and nutritional status of children with cancer from diagnosis to treatment for 6 months To compare the nutritional status of children with lymphoma and solid tumor. Method The nutritional status of 76 children with primary malignant tumors treated in the Department of oncology of Beijing Children's Hospital from July 2019 to November 2021 was analyzed retrospectively. Weight height and upper arm circumference MUAC before initial treatment 1 month 3 months and 6 months after chemotherapy were measured. Nutritional risk screening and nutritional status assessment were conducted at these four time points. The 24-hour dietary intake and blood examination were investigated at the four time points. The complications one month after chemotherapy and nutritional support during 6 months of treatment were collected through medical records. The nutritional status of children with lymphoma and solid tumor were compared. Result The incidence of malnutrition in 76 children before chemotherapy was 15. 8% 12 / 76 32. 9% 25 / 76 at 1 month 25. 0% 19 / 76 at 3 months and 26. 3% 20 / 76 at 6 months after chemotherapy. There were significant differences among the four time points P < 0. 001 . The overweight / obesity rate was 13. 2% 10 / 76 before chemotherapy 7. 9% 6 / 76 at 1 month 5. 3% 4 / 76 at 3 months and 6. 6% 5 / 76 at 6 months after chemotherapy. The difference between the four time points was statistically significant P < 0. 001 There were significant differences in malnutrition score BMI upper arm circumference scan score and total energy intake among the four time points P < 0. 001 . After 3 months of chemotherapy the nutritional status was the worst in 1 month. Comparison between the two groups Six months after chemotherapy dystrophy score 0±0. 9 vs -0. 5±0. 9 BMI 15. 9±2. 1 kg / m 2 vs 14. 8±2. 2 kg / m 2 upper arm circumference 17. 4±2. 0 cm vs 16. 2±2. 9 cm SCAN score 1 1 9 vs 2 1 9 hemoglobin 103. 0±15. 0 g / L vs 94. 2±13. 5 g / L number of malnutrition cases 7 16. 3% vs 13 39. 4% lymphoma group was superior to solid tumor group the difference was statistically significant P< 0. 05 . Conclusion In view of the poor nutritional status of children receiving highintensity chemotherapy nutritional screening and evaluation should be strengthened to find children with nutritional risks as early as possible and actively intervene to improve their tolerance to chemotherapy and quality of life.
2023 Vol. 10 (3): 370-376 [Abstract] ( 223 ) HTML PDF (869 KB)  ( 377 )
377 Value of controlling nutritional status score for evaluating prognosis of patients with epithelial ovarian cancer
Wang Xueyin,Wang Jin
Objective To evaluate the prognostic value of controlling nutritional status CONUT score in patients with epithelial ovarian cancer. Method A total of 158 patients with epithelial ovarian cancer into Jiangning Hospital Affiliated to Nanjing Medical University from January 2017 to June 2020 were retrospectively summarized. The optimal cut - off value of CONUT score before treatment for predicting overall survival OS rate was obtained by receiver operator characteristic ROC curve and the relationship between clinicopathological factors and CONUT score was analyzed. Univariate and multivariate Cox proportional hazard models were used to screen risk factors and Kaplan-Meier analysis was used to analyze the correlation between CONUT score and OS rate. Result The median follow-up time was 35. 0 months the CONUT score was 0-12 points the area under the curve AUC was 0. 775 and the cut-off value was 2. 7. The patients were divided into high-score group ≥ 3 points 71 cases and low-score group < 3 87 cases. The age of patients≥ 58 years old in high-score group FIGO stage Ⅲ-Ⅳ moderate to large amount of ascites neoadjuvant chemotherapy + interval debulking surgery and chemotherapy resistance were significantly higher than those in low-score group P < 0. 05 . Univariate and multivariate Cox analysis showed that CONUT score ≥ 3 points was the independent risk factor to OS P < 0. 05 . The OS rate of high-score group was significantly lower than that of low-score group P< 0. 05 . Conclusion CONUT score of patients with epithelial ovarian cancer is related to patients ' age FIGO stage ascites clinical treatment and chemotherapy resistance. CONUT score ≥ 3 has a good application value in evaluating poor prognosis.
2023 Vol. 10 (3): 377-382 [Abstract] ( 157 ) HTML PDF (1312 KB)  ( 252 )
383 Supplement β-hydroxy-β-methylbutyrate on muscle quality and nutritional outcome in patients with liver cirrhosis
1Zuo Dan,2Huang Biao,3Zuo Bingyu,2Kuang Gang,2Hu Dabi,4Luo Chunli
Objective Research β-hydroxy-β-methylbutyrate HMB on muscle quality and nutritional status of patients with liver cirrhosis. Method The patients with cirrhosis who met the inclusion criteria were selected from August 2021 to August 2022. They were randomly divided into control group n = 30 and test group n = 30 . Both groups were given routine treatment such as liver protection enzyme lowering and nutritional treatment. On the basis of the treatment in the control group the experimental group was treated with oral nutritional supplements rich in HMB . The body weight albumin grip strength skeletal muscle index SMI triceps skinfold thickness TSF arm muscle circumference AMC liver function Child-Pugh grade and Barthel index score of the two groups were compared at three time points 0 3 and 6 weeks . Result The body weight and SMI albumin of patients in the test group were significantly increased and the difference between the two groups was statistically significant P<0. 05 . TSF and AMC decreased in both groups However there was no significant difference between the two groups P>0. 05 . There was no significant difference in Child-Pugh liver function grading and Barthel index between the two groups P>0. 05 . Conclusion Myopenia is more common in patients with liver cirrhosis due to the damage of metabolism and synthesis. This study found that HMB nutrition can improve the function of skeletal muscle and the nutritional status of the body to a certain extent through the intervention of liver cirrhosis patients Inhibit the decomposition of muscle and protein increase the muscle quality of patients but do not improve the damage degree of liver function and personal self-care ability.
2023 Vol. 10 (3): 383-388 [Abstract] ( 134 ) HTML PDF (835 KB)  ( 166 )
389 Investigation and analysis of influencing factors of sarcopenia in elderly inpatients with hypertension
1Yu Yunlan,2Lyu Wanyong,1Yi Haiwei
Objective To understand the detection rate of sarcopenia in hospitalized patients with hypertension and to explore the relationship between sarcopenia and hypertesion and to analyze risk factors for the occurrence of sarcopenia in hypertensive patients. Method 415 elderly patients with hypertension from cardiology department of the first people 's hospital of Lianyungang between January 1 2021 and November 30 2021 were selected according to the inclusion criteria. The patients􀆶 basic information blood indexes nutritional screening anthropometry data and body composition analysis data were collected. All patients were divided into sarcopenia group n = 57 and non-sarcopenia group n = 358 according to the diagnostic criteria for sarcopenia. The relevant indicators of the two groups were compared and the factors that affeted the occurrence of sarcopenia were analyzed. Result In this study 57 patients were diagnosed with sarcopenia. The detection rate of sarcopenia in elderly hypertension was 13. 7%. There were statistically significant differences in age activity mode the grade of hypertension the score of MNA-SF and the score of NRS 2002 between sarcopenia group and non-sarcopenia group P<0. 05 . LDL-C BMI visceral fat area basal metabolic rate and phase in sarcopenia group were smaller than those in non-sarcopenia group P<0. 05 . Systolic blood pressure and diastolic blood pressure were higher than those in non-sarcopenia group P< 0. 05 . Multivariate Logistic regression analysis showed that systolic blood pressure activity mode the grade of hypertension LDL-C and the score of NRS 2002 were not correlated with sarcopenia P>0. 05 . Age diastolic blood pressure BMI and the score of MNA - SF were the influencing factors of sarcopenia in elderly patients with hypertension. Conclusion Advanced age and a high diastolic blood pressure are the risk factors for the occurrence of sarcopenia in the elderly patients with hypertension while overweight obesity and non-malnutrition are the protective factors of hypertension without sarcopenia. Sarcopenia results in lower body composition and higher nutritional risk of hypertensive patients.
2023 Vol. 10 (3): 389-394 [Abstract] ( 172 ) HTML PDF (841 KB)  ( 170 )
395 Study on the relationship between nutritional status and radiation - induced oral mucositis in nasopharyngeal carcinoma during radiotherapy
Xu Wenxiu,Cheng Minqiong
Objective To evaluate the correlation between nutritional status and radiation – induced oral mucositis ROM in nasopharyngeal carcinoma NPC patients during radiotherapy so as to provide a reference for clinical improvement of radiotherapy effect reduction of radiotherapy complication and improvement of nutrition supply. Method A total of 154 patients with NPC diagnosis for the first time into our hospital from May 2020 to May 2022 were enrolled retrospectively. They received intensity modulated radiation therapy IMRT or chemoradiotherapy for at least 4 weeks. Compare the nutritional indicators before and 4 weeks after radiotherapy including body weight body mass index BMI hemoglobin albumin and prealbumin levels and the nutritional risk screening score 2002 NRS 2002 score. After radiotherapy grade of ROM severity according to the American Common Adverse Reaction Terminology Assessment Standard CTCAE Version 5. 0 that is no mild to moderate and severe groups. Compare the nutritional indicators and nutritional intervention methods during the ROM groups. Result The body weight BMI albumin and prealbumin of 154 patients decreased significantly after radiotherapy while the NRS 2002 score increased significantly P< 0. 05 . After radiotherapy there were 41 cases in the non ROM group 91 cases in the mild to moderate group and 22 cases in the severe group. There were no differences among the three groups of all the nutritional indicators before radiotherapy P > 0. 05 . After radiotherapy the weight BMI hemoglobin albumin and prealbumin in the severe group were significantly lower than those in the mild to moderate group and the reduction of each indicator was significantly higher than that in the mild to moderate group the NRS 2002 score and increasement were significantly higher than those in the mild to moderate group too P<0. 05 there were also differences between the mild to moderate group and the non ROM group P<0. 05 . In severe group enteral nutrition was significantly more than that in mild to moderate group the time of parenteral nutrition supply was significantly longer and the total energy of nutrition supply was significantly higher there were also differences between the mild to moderate group and the non ROM group too P<0. 05 . Conclusion ROM occurrence is closely related to nutritional status which can influence and interact with each other in NPC patients during IMRT improving radiotherapy technology and reducing the risk of ROM are important method to improve nutritional status.
2023 Vol. 10 (3): 395-400 [Abstract] ( 158 ) HTML PDF (843 KB)  ( 281 )
401 Establishment and verification of a nomogram for anastomotic leakage after esophageal cancer resection
Bai Chengyun, Li Zhongcheng, Li Wenjun, Liu Yang
Objective To establish a nomogram predictive model for anastomotic leakage in patients with resectable esophageal cancer after radical resection and verify it. Method A method of retrospective case - control study was conducted a total of 588 patients with cT1-3 / N0-1 esophageal cancer diagnosis undergoing radical resection into Affiliated Hospital of Qinghai University from August 2015 to August 2020 were included as the model group. In which 52 patients of anastomotic leakage and other 536 patients of non - anastomotic leakage were diagnosed according to the definition of anastomotic leakage proposed by the esophagectomy complications consensus group ECCG . Lasso regression and multivariate Logistic regression analysis were used to screen risk factors and R software was used to construct a nomogram model. Result In the model group the smoking index≥400 and ASA classification III of patients with anastomotic leakage were higher than those without anastomotic leakage tumor location of the upper and middle part was more surgery time was longer the minimally invasive method was more the linear stapled and Hand-sewn were more the neck anastomosis was more the jejunostomy and nasal-intestinal canal were more and prognostic nutritional index PNI was lower too P < 0. 05 . Lasso regression screening identified the 5 most differential indicators multivariate Logistic regression analysis showed that smoking index ≥ 400 OR = 1. 659 95% CI = 1. 210 - 1. 969 P = 0. 006 ASA grade Ⅲ OR = 1. 968 95% CI = 1. 524-2. 326 P = 0. 002 Hand-sewn anastomosis OR = 3. 002 95% CI = 2. 526- 3. 425 P < 0. 001 neck anastomosis OR = 2. 201 95% CI = 1. 625-2. 458 P = 0. 001 PNI < 50 OR = 3. 652 95% CI = 3. 120-3. 968 P < 0. 001 were the independent predictor of anastomotic leakage. The nomogram predictive model was constructed by R software. Receiver operating curve ROC showed that the area under the curve AUC was 0. 899 which was significantly higher than the AUC value of every single risk factor all P < 0. 001 . The corrective curve showed that the predictive result was in good agreement with actual result P = 0. 663 . Conclusion The occurrence of anastomotic leakage in patients with resectable esophageal cancer after radical resection is closely related to multiple clinical factors. The construction of a quantitative nomogram model has good predictive efficiency which is convenient to guide the early identification of high-risk patients and targeted intervention and has good clinical application value.
2023 Vol. 10 (3): 401-407 [Abstract] ( 148 ) HTML PDF (3141 KB)  ( 113 )
408 Hericium erinaceus polysaccharide combined with different doses of TGF- β1 Effects of miR-302a on the proliferation of gastric cancer cells
Li Xinghai, Shao Jianfu, Liu Shijie, Li Meng, Yang Yanfang, Yan Yu
Objective To study the effects of hericium ericium polysaccharide combined with different doses of transforming growth factor-β1 TGF-β1 on the proliferation and micro RNA-302a miR-302a of gastric cancer cells. Method Gastric adenocarcinoma cells poorly differentiated BGC- 823 and SGC7901 were cultured. TGF-β1 group and hericium erinaceus polysaccharide+TGF-β1 group were set. According to the dose of TGF - β1 0 g / L control group 1 g / L group 5 g / L group and 10 g / L group were divided. MTT assay was used to detect the proliferation of cancer cells after 6 h 12 h 24 h 48 h and 72 h culture of TGF - β1. Real-time fluorescence quantitative RT-PCR was used to detect the expression of miR-302a. The expression of phosphorylated AKT p-AKT and 3-carboxyphosphatidylinositol kinase p-PI3K were detected by Western blotting. TGF-β1 was transfected into BGC-823 and SGC7901 cells respectively and TGF-β1 and negative control NC groups were recorded. Result The proliferation inhibition rate of BGC-823 and SGC790 cells in two groups increased gradually with the extension of treatment time and the increase of TGF-β1 dose. The proliferation inhibition rate of hericium ericium polysaccharide +TGF-β1 group was higher than that of TGF-β1 group P < 0. 05 . The inhibitory effect of 5 and 10 g / L TGF-β1 groups on SGC790 cells was similar after 48 ~ 72 h which had statistical significance compared with other groups P < 0. 05 . Compared with 0 g / L the number of cell clones in two groups at 1 5 and 10 g / L dose was gradually decreased and the number of cell clones in 10 g / L dose group was most significantly decreased P < 0. 05 . Compared with 0 g / L the apoptosis rate of gastric cancer cells BGC-823 and SGC7901 was increased by 1 5 10 g / L doses of TGF-β1 P< 0. 05 after 48 h treatment with TGF-β1 P< 0. 05 . The expression of miR-302a in each dose group was higher than that in TGF-β1 group P< 0. 05 . The expression of p-Akt and p-PI3K decreased with the increase of dose of TGF-β1 in all groups and the decrease was more significant in hericium ericium polysaccharide +TGF-β1 group P < 0. 05 . Western blotting indicated that the expression of miR- 302a may be negatively regulated by TGF-β1 via p -AKT and p - PI3K. Conclusion The proliferation of gastric adenocarcinoma cells BGC - 823 and SGC7901 and the number of cell clones were more effectively inhibited by the polysaccharide +TGF-β1. The expression of miR-302a may be negatively regulated by TGF-β1 via p-AKT and p-PI3K.
2023 Vol. 10 (3): 408-414 [Abstract] ( 103 ) HTML PDF (1210 KB)  ( 153 )
415 NLR combined with PLR predicted muscle mass loss in patients with primary liver cancer
1 Ni Peiping,1 Chen Li,1 Wu You,2Lyu Muhan,1Wang Min
Objective To investigate the relationship between neutrophil to lymphocyte ratio NLR platelet to lymphocyte ratio PLR and muscle mass loss in patients with primary liver cancer. Method 328 primary liver cancer patients were included in a retrospective study. Cross sectional skeletal muscle index SMI of the third lumbar vertebra was Computed with Computed Tomography CT . The risk factors of muscle loss were analyzed by Logistic regression and the optimal cut-off values of NLR and PLR were determined according to receiver operating characteristics ROC curve. The area under the curve AUC was used to evaluate the predictive effect of each indicator on muscle loss in primary liver cancer patients. Result 328 primary liver cancer patients included 269 male patients and 59 female patients and the incidence of total muscle mass loss was 61. 89%. ROC curve showed that the optimal cut-off values of NLR and PLR were 4. 04 and 163. 01 respectively and the AUC values were 0. 629 95%CI = 0. 569-0. 690 P < 0. 001 0. 608 95%CI = 0. 546- 0. 670 P = 0. 001 the AUC value of primary liver cancer muscle mass loss predicted by NLR combined with PLR was 0. 643 which was better than that predicted by NLR and PLR alone. NLR combined with PLR score 0 score NLR≤4. 04 and PLR≤163. 01 Score NLR > 4. 04 or PLR > 163. 01 2 scores NLR > 4. 04 and PLR > 163. 01 could further stratify the loss of muscle mass in primary liver cancer patients and the difference between groups was statistically significant χ2 = 24. 262 P < 0. 001 . Conclusions NLR and PLR are independent predictors of muscle mass loss in primary liver cancer patients and their combination is more likely to identify primary liver cancer patients with muscle mass loss.
2023 Vol. 10 (3): 415-422 [Abstract] ( 134 ) HTML PDF (3213 KB)  ( 170 )
423 The predictive value of L3 skeletal muscle index SMI for sarcopenia in advanced non-small cell lung cancer patients
1Wang Qingdong,1Zeng Yunfei,2Wu Dongqing
Objective This study aimed to analyze the correlation between the third lumbar skeletal muscle index L3 -SMI and nutritional status and to clarify whether L3 -SMI could be used as an effective predictor of malnutrition for advanced non-small cell lung cancer NSCLC patients. Method A total of 100 clinical stage Ⅲ - Ⅳ NSCLC patients who received radiotherapy and / or chemotherapy in Funing People's Hospital from Jan 2016 to Dec 2020 were enrolled in this analysis and all patients were divided into severe malnutrition and non-severe malnutrition groups based on the patient-generated subjective global assessment PG-SGA . The correlations between different assessment parameters and severe malnutrition risk were determined using the univariate and multivariate Logistic regression analysis and the receiver operation characteristics ROC curves were plotted to compare these predictive values for severe malnutrition risk in advanced NSCLC patients. Result Using the PG-SGA scale we found that frequency of severe malnutrition in advanced NSCLC patients could be as high as 48. 0% . Compared with the non -severe malnutrition group patients with severe malnutrition were older 65. 4± 10. 0 vs 61. 2 ± 6. 9 years old t = 2. 482 P = 0. 015 and had a higher score of Controlling nutritional status 3 1 5 vs 2 1 4 t = 2. 238 P = 0. 027 lower body mass index 21. 1±3. 2 kg / m 2 vs 25. 2±3. 8 kg / m 2 t = -5. 840 P<0. 001 serum albumin level 33. 8±4. 7 vs 36. 4±3. 9 g / L t = -2. 970 P= 0. 004 the prognostic nutritional index 41. 5±5. 3 vs 44. 7±5. 0 t = -3. 122 P= 0. 002 and L3 -SMI 36. 0±8. 9 vs 53. 1±12. 3 t = -8. 103 P<0. 001 . The multivariate Logistic regression analysis demonstrated that low serum albumin level OR = 0. 791 95%CI = 0. 678- 0. 922 P = 0. 003 and L3 -SMI OR= 0. 826 95%CI = 0. 765-0. 892 P<0. 001 were independently correlated with severe malnutrition risk in advanced NSCLC patients. In addition ROC curves showed that L3 -SMI had an excellent predictive performance with an AUC value of 0. 888 95%CI = 0. 822 - 0. 955 which was higher than other hematological parameters. Conclusion L3 -SMI was significantly correlated with PG-SGA scale and it was an useful tool of nutrition risk screening for advanced NSCLC patients.
2023 Vol. 10 (3): 423-429 [Abstract] ( 163 ) HTML PDF (2169 KB)  ( 142 )
430 Advances in effect of bile acid metabolism on cholesterol gallstone disease
Ma Xianhao, Sun Yanbo, Cen Yunyun, Xu Pengyuan
Gallstones are a common and frequently occurring digestive disease with cholesterol stones being the most prevalent type. Intestinal flora gallbladder function environment genetics and cholesterol metabolism are just a few of the factors that play a role in the mechanism of cholesterol stones at this time. Clinical research on how to prevent and treat cholesterol stones has become a hot topic and challenge. According to some studies hydrophilic bile acid drugs can help prevent and treat some gallstones proving that bile acid is a key factor in the formation of gallstones. It is not only a crucial component of bile that aids in the breakdown and absorption of human lipids but it is also one of the cholesterol's metabolites. The stability of cholesterol in bile must be maintained in order to avoid cholesterol stones from developing. In bile cholesterol phospholipid bile acid and other organic components typically remain in a reasonable ratio preventing cholesterol crystals from easily depositing and forming stones. However when bile acid synthesis secretion transport uptake and reabsorption are abnormal bile acid pool will be reduced bile homeostasis is unbalanced and cholesterol oversaturation will precipitate and cause stone formation. In addition bile acid metabolism problems will worsen gallbladder problems alter intestinal flora and hasten the development of cholesterol stones. This paper reviews the relationship between bile acid metabolism and the pathogenesis of cholesterol stones and the most recent advances in research in order to better understand the internal relationship between the aforementioned mechanisms.
2023 Vol. 10 (3): 430-436 [Abstract] ( 227 ) HTML PDF (2169 KB)  ( 428 )
437 The role and potential therapeutic value of tumor-associated macrophages in colorectal cancer
1Xu Shaoqiang,1Liu Chengfei,2Yao Tian,2Huang He
Colorectal cancer CRC is a common malignant tumor of the digestive system and its occurrence and development are not only related to the characteristics of tumor cells themselves but also closely related to the tumor microenvironment TME . As an important component of TME tumor-associated macrophages TAMs regulate a variety of key oncogenic processes in CRC promote tumor genesis proliferation and metastasis by secreting cytokines and chemokines and coordinating with inflammatory mechanisms. Based on the impact of TAMs on tumor progression the current therapeutic strategies targeting tumor macrophages mainly focus on TAMs as targets for immunotherapy inhibition of macrophage recruitment reinduction of phenotypic polarization of TAMs and combination of TAMs targeted therapy with conventional treatment. Therefore the growing understanding of the functional and regulatory mechanisms of TAMs will allow us to effectively explore their clinical application in colorectal cancer. In this review we describe the role and related mechanisms of TAMs in the occurrence and progression of colorectal cancer and based on the above summarize the potential therapeutic strategies for colorectal cancer related to TAMs so as to provide emerging treatment ideas and methods for the diagnosis and treatment of CRC which has effective reference value.
2023 Vol. 10 (3): 437-443 [Abstract] ( 211 ) HTML PDF (1447 KB)  ( 187 )
444 A review on the research progress and application of comprehensive geriatric assessment for community - dwelling older people
Liu Beibei, Liu Zhen, Zhang Jian
The comprehensive geriatric assessment CGA is a multidimensional and interdisciplinary evaluation approach for the elderly people that aims to identify potential health problems and functional deficits in multiple aspects of individuals. The current foreign CGA instruments are more standardized and systematic than Chinese including European Assessment System for Care of Old People Multidimensional Prognostic Index Patient - Reported Outcomes Measurement Information System. In China research institutions based on certain theoretical frameworks select evaluation contents of various dimensions and conduct verification of the reliability and validity of the entire scale which mostly applied in single scenarios. Currently domestic and foreign CGA studies focus more on emergency and hospitalized patients with less attention to the elderly population in the community. Furthermore there is a lack of evidence - based medicine evidence and prospective and intervention studies in the implementation of community elderly comprehensive evaluation in China. This review article provides the development and application of CGA instruments in community-dewelling people both domestically and internationally. It also explores the problems currently faced by community elderly CGA research and potential solutions in order to move the front line of preventing and controlling health risks for the elderly delay the occurrence and development of adverse events reduce the burden of care in society and improve the quality of life for the elderly.
2023 Vol. 10 (3): 444-448 [Abstract] ( 196 ) HTML PDF (835 KB)  ( 835 )
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