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2024 Vol. 11, No. 2
Published: 2024-04-09
 
145 Damage control surgical treatment strategy for intestinal obstruction in colorectal cancer patients
Jiang Hua,Sun Mingwei,Cai Bin
Intestinal obstruction is a common complication in colorectal cancer patients and is one of the major causes that result in emergency services. When patients are admitted to the emergency department their primary tumors are often in advanced stages and with combined presence of fluid-electrolyte imbalance and malnutrition and they are often in a state of severe metabolic instability. If patients are not managed properly in time the risk of poor prognosis is extremely high. Traditionally emergency operation is the first choice in the management of acute intestinal obstruction in such conditions. However in patients with acute malignant intestinal obstruction the risk of complications and death are significantly higher after emergency operations than elective operations due to the influences by metabolic instability and the tumor. With the rapid development of the damage control surgery DCS we believe that it should be introduced to manage patients with acute malignant intestinal obstruction. With technological advances DCS treatment for malignant intestinal obstruction has become more minimally invasive especially with the application of endoscopic interventions such as decompression tubes DT and self - expanding metal stents SEMS . These endoscopic advances make emergency operations unnecessary in most malignant intestinal obstruction patients so elective surgery can be performed after significant improvements in fluid-electrolytes balance nutritional status and relief of severe inflammatory reactions. In conclusion for colorectal cancer patients with malignant intestinal obstruction the goal of emergency treatment should be limited to relieve the obstruction rather than radical resection. Through the comprehensive application of minimally invasive techniques such as SEM DT and nutrition therapy most patients would not undergone emergency operation and can expect elective surgery in a more stable condition thereby achieving better clinical outcomes.
2024 Vol. 11 (2): 145-148 [Abstract] ( 161 ) HTML PDF (831 KB)  ( 83 )
149 Targeting glutamine metabolism to enhance anti-tumor immunity and immunotherapy
Wang Chunyan,Meng Xiangyu,Huang Lan
Metabolic reprogramming and immune escape play important roles in tumor development recognized as two hallmarks of cancer. The success of immune checkpoint inhibitors has opened a new era of immunotherapy for cancer treatments. Accumulating evidence suggests that metabolic adaptation of cancer cells contributes to tumor immune evasion. With high levels of metabolic activity cancer cells change metabolic pathways to meet the needs for uncontrolled growth and proliferation. The high demand for glutamine leads to many types of cancer addicted to glutamine. Altered glutamine metabolism has a significant impact on tumor invasiveness and remodeling of the tumor microenvironment. Glutamine is also a vital nutrient for the proliferation and activation of immune cells. The abundant consumption of glutamine by cancer cells can lead to immunosuppressive tumor microenvironment and resistance to immune checkpoint inhibitor therapy. In this review we provide an updated overview of glutamine metabolism of tumor cells and its involvement in tumor immune evasion and explore the potential applications of targeting glutamine metabolism to enhance anti-tumor immunity and immunotherapy.
2024 Vol. 11 (2): 149-156 [Abstract] ( 193 ) HTML PDF (2598 KB)  ( 118 )
157 Conceptual distinction between sarcopenia and cachexia in cancer patients
Zhang Fengmin,Wu Haofan,Zhuang Chengle
Sarcopenia is a progressive skeletal muscle disease characterized by a pathological decrease in muscle mass and function and is common in the elderly. Most cancer patients are elderly and patients may already have sarcopenia before the onset of cancer. Additionally cancer promotes muscle aging making cancer patients more susceptible to sarcopenia. Cachexia another common multifactorial syndrome in cancer patients manifests as anorexia involuntary weight loss and persistent skeletal muscle wasting which cannot be fully reversed by conventional nutritional therapy and may eventually lead to progressive functional impairment. Sarcopenia and cachexia share many similarities in their causes and characteristics. For example loss of muscle mass is a common diagnostic factor in both syndromes thus sarcopenia and cachexia are often referred to as each other in cancer patients. Therefore it is of great significance to elaborate on their characteristics and differences in cancer patients. Here we provide a comprehensive comparison of sarcopenia and cachexia in cancer patients elucidate the similarities and differences between the two diseases and provide evidence-based strategies for the management of cancer patients with sarcopenia.
2024 Vol. 11 (2): 157-163 [Abstract] ( 145 ) HTML PDF (1277 KB)  ( 107 )
164 Damage control surgery combined with enteral nutrition improve the nutritional status of patients with cancerous intestinal obstruction
Zhang Ruipeng,Wang Lu,Sun Mingwei
Malnutrition is common in cancer patients. Due to the rapid growth and metabolic activity of tumors themselves the body requires more energy and nutrients and some treatment methods such as surgery radiation therapy and chemotherapy can further increase the metabolic burden. Intestinal obstruction can be found in gastrointestinal malignancies patients. Patients' intake is further restricted and the incidence of malnutrition increases. Malnutrition can reduce physical function increase the risk of infection and complications and harder postoperative recovery. Surgical treatment in cases of overall functional decline caused by malnutrition will further increase the mortality rate of patients. At present surgical treatment is the main treatment option for patients with cancerous ileus. However malnutrition will increase the postoperative mortality of these patients. Therefore improving the nutritional status of patients has become the key point in the treatment of patients with cancerous intestinal obstruction. Damage control surgery combined with enteral nutrition is more suitable for improving the nutritional status of patients with cancerous intestinal obstruction. Intestinal obstruction can be solved via decompression tubes or self-expanding metal stents under gastrointestinal endoscopy to open nutritional access improve the nutritional status of patients build a bridge between radical surgery within a limited period and improve the prognosis of patients.
2024 Vol. 11 (2): 164-168 [Abstract] ( 69 ) HTML PDF (436 KB)  ( 59 )
169 Expert consensus on clinical application of nutritional oncology therapy system based on patient-reported outcome
Chinese Association for Clinical Oncologists,Chinese Society of Nutritional Oncology
Clinical outcome measures are essential to evaluate the effects of treatment and the quality of healthcare service. Traditional measures often overlook patients' subjective experiences leading to a growing focus on patient-reported outcomes PRO in recent years. In the field of oncology PRO may cover symptom assessment and monitoring satisfaction with care and inform treatment decisions and health policy. The increasing recognition of the electronic patient - reported outcome ePRO system in nutritional oncology highlights its potential for enhancing the efficiency of nutritional intervention reducing the burden on healthcare professionals and encouraging patient engagement in nutrition interventions. With the rise of artificial intelligence future clinical support systems based on PRO hold the promise of transforming traditional decision -making models further optimizing healthcare service quality. Therefore based on expert opinions and existing evidence this consensus offers recommendations for the standardized application of ePRO systems in clinical practice and research aiming to promote efficiency and comprehensiveness of nutritional management in oncology settings.
2024 Vol. 11 (2): 169-180 [Abstract] ( 225 ) HTML PDF (1304 KB)  ( 155 )
181 Expert consensus on high-dose vitamin C therapy for Cancer 2024
1Rao Benqiang,1Wang Shiwan,1Shi Hanping,1Qu Jinxiu,1Lu Shuai,1Wang Bing,1He Jia,1Zhao Yuan,2Tang Huazhen,1Wang Lin,1Wang Xin,1Zhang Zhanzhi,1Chen Yongbing,1Zhu Qiankun,1Zhang Xiaowei
The efficacy of high - dose vitamin C HDVC treatment for tumors is fragile and requires precise and intensified treatment. However there is not only an absence of standardized therapeutic schedule of HDVC for cancers but also a lack of high-quality guidelines for precise and intensive treatment of HDVC for tumors which seriously affects the therapeutic effect and clinical application of HDVC. Based on in-depth discussions on the anti-tumor mechanisms and the pharmacokinetic characteristics of of HDVC experts with rich experience in the Nutrition Therapy Professional Committee of China Anti - Cancer Association the Research Committee of New Anti-Cancer Drugs for Chinese and Western Integrated Tumor Control and the Nutrition Metabolism Branch of China Elderly Care Association have reached a consensus on the indications and contraindications of HDVC clinical advantage administration the prevention and treatment of side effects the sensitivity and precision treatment of metabolic molecular phenotype the intensive treatment strategy and efficacy monitoring. This consensus will help improve the the standardization and efficacy of of high dose vitamin C treatment against cancer.
2024 Vol. 11 (2): 181-186 [Abstract] ( 995 ) HTML PDF (2009 KB)  ( 335 )
187 Effect of high dose vitamin C on proliferation and glucose uptake in lung cancer A549 cells
Du Yanping, Ou Junwen, Liu Manting, Lu Zhitong, Wu Xiaofeng
Objective To investigate the effects of high-dose vitamin C on proliferation and glucose uptake in lung cancer A549 cells. Method The IC50 value of A549 cells treated with vitamin C was analyzed by CCK8 method. Different concentrations of vitamin C the final concentration was 0-8 mmol / L were applied to A549 cells for 24 hours and glucose concentrations were set at 5 mmol / L and 25 mmol / L respectively. Cell proliferation was detected by CCK8 method. A549 cells were interfered with 8 mmol / L vitamin C and intracellular vitamin C concentration was detected by FRASC Ascorbic acid kit Ⅱ. Human bronchial epithelioid cells HBE cell were used as a control to analyze the time change of intracellular vitamin C concentration for 4 h. A549 cells were then divided into four groups and interfered with 5 mmol / L glucose 5 mmol / L glucose + 8 mmol / L vitamin C 25 mmol / L glucose or 25 mmol / L glucose + 8 mmol / L vitamin C. Intracellular vitamin C concentration was detected and intracellular glucose intake was detected by using fluorescence-labeled 2-deoxyglucose as a probe. The expression levels of glucose transporters 1 and 3 GLUT1 and GLUT3 were detected by qPCR and Western Blot. Result The IC50 concentration of A549 cells treated with vitamin C for 24 h was 5. 192 mmol/ L. The inhibitory effect of vitamin C on A549 cell proliferation was enhanced with the increase of concentration P< 0. 05 and the cell viability of A549 cells after 5 mmol / L glucose intervention was lower than 25 mmol / L glucose when the concentration of vitamin C was 4 or 8 mmol / L P<0. 05 . Vitamin C concentration in A549 cells increased with time and was significantly higher than that in HBE cells at 0. 5 1 2 and 4 h P<0. 05 . After 8 mmol / L vitamin C intervention for 24 h the intracellular glucose intake of A549 cells was decreased P<0. 05 and after 25 mmol / L glucose intervention the intracellular vitamin C concentration was lower than 5 mmol/ L glucose P<0. 05 . When glucose concentration was 5 mmol / L the expression levels of RNA and protein of GLUT1 and GLUT3 were decreased after 8 mmol / L vitamin C intervention P< 0. 05 while the RNA level of GLUT3 and the protein level of GLUT1 were decreased when glucose concentration was 25 mmol / L P< 0. 05 . Conclusion At low glucose concentration high-dose vitamin C down-regulated the expression of GLUT1 and GLUT3 decreased glucose uptake in A549 cells and inhibited the proliferation of A549 cells.
2024 Vol. 11 (2): 187-194 [Abstract] ( 92 ) HTML PDF (6218 KB)  ( 33 )
195 Randomized controlled trial of MCT ketogenic diet in patients with breast cancer over 3 months of chemotherapy
Liu Liu, Zhang Yuanyuan, He Zhen, Wu Bei, Xu Yang, Cao Wei
Objective To analyze the application value of medium-chain triglyceride MCT based ketogenic diet in breast cancer patients receiving chemotherapy for more than 3 months. Method A total of 120 patients with breast cancer receiving chemotherapy intervention for more than 3 months were enrolled in the Oncology Department of Wuhan Third Hospital from March 2021 to March 2023 and were simply randomly divided into control group n = 60 and intervention group n = 60 . Among them the control group received traditional chemotherapy diet intervention and the intervention group received MCT-based ketogenic diet intervention. Both groups were subjected to clinical observation for 5 weeks. Blood ketone blood glucose and body weight of the two groups were compared before intervention after 1 2 3 and 5 weeks of intervention. Meanwhile the inflammatory indexes CRP TNF - α interleukin- 1β immune indexes CD3 + CD4 + CD8 + and the dominant bacteria group of intestinal hilum Firmicutes Bacteroidetes and Morphomycetes were compared between the two groups. The incidence of variant bacteria adverse reactions nausea vomiting diarrhea constipation and hypoglycemia were different. Result After 1 to 5 weeks of intervention blood ketone levels in the intervention group were higher than before intervention. Moreover the blood ketone in the intervention group was higher than that in the control group 1. 84±0. 12 mmol / L vs 0. 41±0. 10 mmol / L 2. 10±0. 11 mmol / L vs 0. 42±0. 09 mmol / L 2. 01±0. 15 mmol / L vs 0. 44±0. 10 mmol / L 2. 00±0. 19 mmol / L vs 0. 43±0. 08 mmol / L P<0. 05 . After 1 to 5 weeks of intervention the blood glucose level in the intervention group was higher than before intervention and the blood glucose level in the intervention group was lower than that in the control group P<0. 05 . After 5 weeks of intervention body weight decreased in both groups compared with before intervention P<0. 05 . After intervention CD3 + and CD4 + in the intervention group were higher than those in the control group 70. 15 ± 6. 07 mmol / L vs 57. 62 ± 5. 09 % and 54. 02 ± 5. 62 % vs 43. 06 ± 4. 98 % . CD8 + 30. 62±3. 45 % vs 35. 62±3. 11 % and inflammation index were lower than control group P<0. 05 . After the intervention the abundances of Firmicutes and Morphomycetes in both groups decreased and Bacteroidetes increased and the abundances of Bacteroidetes in the intervention group was higher than those in the control group while those in the Firmicutes and variant Morphomycetes were lower than those in the control group P<0. 05 . The total incidence of adverse reactions in the intervention group 13. 33% 8 / 60 was significantly lower than that in the control group 31. 67% 19 / 60 P<0. 05 . Conclusion For breast cancer patients who have received chemotherapy for more than 3 months ketogenic diet intervention based on MCT can improve the overall health status of patients and reduce the side effects of chemotherapy etc. Ketogenic diet treatment of breast cancer is safe and feasible and can provide references for clinical breast cancer chemotherapy treatment and improvement of adverse reactions.
2024 Vol. 11 (2): 195-200 [Abstract] ( 83 ) HTML PDF (430 KB)  ( 93 )
201 Construction and application of evidence-based practice protocol for early postoperative oral feeding in patients with gastric cancer after gastrectomy
1Liu Shuying,2Wang Yaling,1Liu Guo,3Deng Xiaolian,4Yao Juan,2He Haiyan
Objective To evaluate the effect of an evidence - based early postoperative oral feeding protocol for patients after gastrectomy. Method According to the "6S" model of the evidence pyramid we systematically searched for domestic and international expert consensus systematic evaluation evidence summaries and guidelines related to early post - operative oral diet for gastric cancer and then formulated an evidence-based nursing practice plan in combination with clinical reality. Patients who underwent gastric cancer resection surgery in Daping Hospital were selected in which 105 patients from January 2020 to April 2021 before the evidence-based nursing practice were the control group and 141 patients from May 2021 to December 2022 were the evidence-based nursing practice group. The practice group underwent early postoperative transoral dietary intervention and outcome indicators such as postoperative transoral dietary initiation time anastomotic leakage / residual leakage gastric tube retention time anal gas defecation time postoperative hospitalisation days and hospitalisation costs were compared between the two groups. Result In the practice group postoperative transoral diet start time was shortened from 6 3 8 d to 1 1 4 d gastric tube retention time was shortened from 5 4 7 d to 3 0 4. 75 d anal defecation time was shortened from 4 4 6 d to 3 3 4 d postoperative bowel movement time was shortened from 5 4 6 d to 4. 5 3 5 d and postoperative hospitalisation days were shortened from 10 9 12 d to 8 7 9 d and the hospitalisation cost was reduced from ￥ 74 400 66 600 88 100 to ￥ 58 600 53 300 69 000 with the differences being statistically significant P < 0. 05 There was no significant difference in postoperative anastomotic leakage / residual leakage P > 0. 05 . There was no significant difference in leukocyte count neutrophil count lymphocyte count hemoglobin level and serum albumin level between experimental group and control group P>0. 05 . Conclusion An evidence-based early postoperative oral feeding protocol for gastric cancer after surgery can accelerate the recovery of gastrointestinal function without increasing leakage but the impact on inflammation and nutritional status during hospitalization is not significant.
2024 Vol. 11 (2): 201-209 [Abstract] ( 90 ) HTML PDF (2162 KB)  ( 76 )
210 Effect of anti - inflammatory diet intervention on nutritional status and immune function of patients with lung cancer undergoing chemotherapy
Lin Qingxiu, Xie Kunming, Lyu Li
Objective Analyze the application effect of nutritional support management based on anti -inflammatory diet in lung cancer chemotherapy patients. Method A total of 122 patients with lung cancer who received chemotherapy in the First Medical Center of the Chinese People's Liberation Army General Hospital from January 2021 to December 2022 were selected and divided into the control group 61 cases and the experimental group 61 cases by random number table method. The control group was given conventional nutritional support and the experimental group was given nutritional support management based on anti -inflammatory diet. Nutritional status T lymphocyte subsets immune function body weight PG-SGA score Cancer Quality of Life Scale FACT score clinical therapeutic efficacy and adverse reactions were compared between the two groups before and after intervention. Result From the analysis of efficacy and safety the total effective rate of clinical treatment in the study group was 59. 02% which was significantly higher than the 39. 34% in the control group P < 0. 05 . The incidence of adverse reactions in the study group was 16. 39% which was significantly lower than the 39. 34% in the control group P<0. 05 . From the perspective of nutritional status after intervention the study group showed significantly higher levels of albumin ALB 37. 91 ± 3. 28 g / L vs 34. 51 ± 3. 39 g / L total protein PA 389. 24 ± 30. 34 mg / L vs 356. 71 ± 28. 74 mg / L hemoglobin Hb 11. 54 ± 2. 67 g / L vs 8. 63 ± 2. 24 g / L body weight 55. 74 ± 1. 24 kg vs 52. 36 ± 1. 29 kg and quality of life scores The PG-SGA score 5. 28 ± 0. 45 points vs 8. 90 ± 0. 35 points was significantly lower than the control group P<0. 05 . From the perspective of immune function after intervention the CD4 + proportion 38. 53 ± 4. 34 % vs 25. 66 ± 3. 21 % CD4 + / CD8 + proportion 1. 32 ± 0. 38 % vs 0. 63 ± 0. 21 % NK proportion 46. 83 ± 6. 17 % vs 30. 3 ± 4. 33 % IgA IgG and IgM in the study group were significantly higher than those in the control group P<0. 05 . Conclusion Nutritional support management based on anti-inflammatory diet can significantly improve the treatment effect nutritional status and immune function of lung cancer chemotherapy patients and its application safety is guaranteed to a certain extent.
2024 Vol. 11 (2): 210-215 [Abstract] ( 111 ) HTML PDF (857 KB)  ( 61 )
216 Application of nutritional status assessment in chemotherapy tolerance of patients after total gastrectomy
Wang Xianfang, Yan Dong, Tang Mengqian, Li Ying, Liang Pengyan
Objective To explore the application of nutritional status assessment in chemotherapy tolerance of patients after total gastrectomy. Method 154 gastric cancer patients who received radical total Gastrectomy and postoperative chemotherapy from March 2018 to February 2022 in Beijing Luhe Hospital Capital Medical University were included as the study subjects. According to whether the patients stopped chemotherapy within 6 months after surgery they were divided into tolerance group n = 122 and intolerance group n = 32 . Kaplan Meier curve was used to analyze the relationship between the stratification of chemotherapy duration and the survival rate of patients after total gastrectomy Single factor logistic regression was used to analyze the influencing factors of chemotherapy tolerance in patients after total gastrectomy and Receiver operating characteristic was drawn to analyze the predictive value of related factors. Result Kaplan Meier survival curve analysis showed that chemotherapy tolerance of patients after total gastrectomy was related to overall survival rate Log Rank Mantel Cox = 11. 017 P = 0. 001 . Age basic diseases nutritional risk screening 2002 NRS 2002 prognostic nutritional index PNI carcinoembryonic antigen CEA albumin ALB and hemoglobin Hb of the patients in the two groups. The variables in univariate analysis P<0. 05 were included in multivariate Logistic regression model and the results showed that age OR= 6. 150 PNI OR = 3. 263 Hb OR = 1. 090 and ALB OR = 1. 342 were the independent risk factors of chemotherapy tolerance of patients after total gastrectomy P<0. 05 . The ROC curve shows that the area under the curve AUC of age is 0. 694 95%CI = 0. 615-0. 766 that of PNI is 0. 774 95%CI = 0. 700-0. 838 that of Hb is 0. 893 95%CI = 0. 833-0. 937 and that of ALB is 0. 814 95% CI = 0. 743 - 0. 872 . Conclusion Older age low prognostic nutritional index and low levels of hemoglobin and albumin are risk factors for chemotherapy tolerance in patients after total gastrectomy among which hemoglobin and albumin levels have significant predictive efficacy on chemotherapy tolerance of patients after total gastrectomy and need to be used as predictive indicators for postoperative chemotherapy tolerance of patients with gastric cancer.
2024 Vol. 11 (2): 216-221 [Abstract] ( 76 ) HTML PDF (1532 KB)  ( 56 )
222 Application study of personalized nutritional intervention based on WeChat app in nutrition complications and quality of life of postoperative gastric cancer patients
Zhai Lili, Ouyang Lanfei, Li Cheng
Objective To explore the application effect of personalized nutrition intervention based on WeChat mini-program in postoperative patients with gastric cancer. Method A total of 102 patients who received radical surgery for gastric cancer in a tertiary hospital from January 2022 to December 2022 were selected and randomly divided into intervention and control groups 51 cases in each group. The control group adopted conventional nutritional management measures and the intervention group adopted personalized nutritional intervention based on WeChat mini - programs on the basis of the control group. The patients in the two groups were compared before the intervention 1 month 3 months and 6 months after patient-generated subjective global assessment PG-SGA score the rate of postoperative complications and quality of life scale EORTC QLQ-C30 . Result The nutritional status of patients in the intervention group was better than that of the control group at 1 month 3 months and 6 months after operation and the difference was statistically significant in the group with good nutritional status P<0. 05 . The incidence of postoperative complications in the intervention group was lower than that in the control group. The scores of each dimension of quality of life in the intervention group were higher than those in the control group and the difference was statistically significant P<0. 05 . Conclusion Personalized nutritional intervention based on WeChat mini-program can significantly improve the nutritional status of patients reduce the rate of postoperative complications and improve the quality of life of patients.
2024 Vol. 11 (2): 222-228 [Abstract] ( 108 ) HTML PDF (868 KB)  ( 144 )
229 Correlation study of treatment self-regulation perceived social support and nutritional literacy in patients with breast cancer undergoing chemotherapy
Chen Shi, Zhou Yuhong
Objective To explore the status of nutritional literacy of breast cancer patients undergoing chemotherapy and explore its correlation with treatment self - regulation and perceived social support. Method 256 patients with breast cancer who received chemotherapy treatment in Nantong Cancer Hospital from November 2021 to April 2023 were selected by convenience sampling method as the survey objects. The general information questionnaire nutrition literacy measurement scale for Chinese adults NLMS-CA Chinese version of the treatment self regulation questionnaire TSRQ-C perceived social support scale PSSS surveys breast cancer patients undergoing chemotherapy. Result The NLMS-CA score of patients with breast cancer undergoing chemotherapy was 151. 38± 16. 74 points. Some dimensions scores and total scores of TSRQ-C and PSSS of other breast cancer chemotherapy patients were positively correlated with the scores and total scores of all dimensions of NLMS-CA and the differences were statistically significant all P<0. 05 . The results of multiple linear regression analysis showed that the differences in NLMS-CA scores between patients with different age place of residence cultural level and disease stage and breast cancer chemotherapy were statistically significant all P < 0. 05 . Conclusion The average nutritional literacy level of patients with breast cancer undergoing chemotherapy is relatively good. Clinical medical workers can formulate targeted intervention management measures to improve patients' self treatment adjustment ability and perceived social support level thereby helping patients improve their nutritional literacy and promote health outcomes.
2024 Vol. 11 (2): 229-235 [Abstract] ( 80 ) HTML PDF (863 KB)  ( 123 )
236 Applicability analysis of three nutritional assessment tools under GLIM standard in elderly patients with digestive system tumors
1,2Yang Jiayao,3Wang Shu'an,2Gu Jingyue,2Xu Yan,2Shao Jihong,2Huang Shuiping
Objective To explore the applicability of patient -generated subjective nutrition assessment PG-SGA prognostic nutrition index PNI and geriatric nutrition risk index GNRI in the nutritional assessment of elderly patients with digestive system tumors based on Global Leadership Initiative on Malnutrition criteria GLIM . Method Elderly patients who underwent digestive system tumor resection in Affiliated Hospital of Xuzhou Medical University from March 2021 to June 2022 were selected. With GLIM as the " gold standard" for the diagnosis of malnutrition PG-SGA PNI and GNRI were used for nutritional assessment and the sensitivity、 specificity、positive predictive value and negative predictive value were calculated and compared. The receiver operating characteristic ROC curve was plotted and the area under the curve AUC was compared by Delong test to explore the clinical value of each tool comparison between groups was conducted. Result The positive rate of malnutrition diagnosed by GLIM was 29. 3%. The positive rates of PG-SGA PNI and GNRI were 37. 0% 44. 0% and 45. 7% respectively. The body mass index muscle loss and phase angle indexes were worse in the patients with malnutrition and the serum albumin ALB prealbumin PA and hemoglobin HB indexes were decreased with statistical significance P < 0. 05 . Compared with GLIM standard PG - SGA showed the worst sensitivity 44. 1% and middle specificity 65. 9% with no diagnostic consistency Kappa = 0. 09 P = 0. 311 The sensitivity 61. 8% and specificity 63. 4% of PNI were average and there was weak agreement with GLIM diagnosis Kappa = 0. 22 P= 0. 013 . GNRI had the best specificity 88. 2% and sensitivity 72. 0% and had a good concordance with GLIM diagnosis Kappa = 0. 52 P<0. 001 . In the ROC curve GNRI had the highest predictive value AUC= 0. 817 95%CI = 0. 734-0. 882 followed by PNI AUC = 0. 621 95%CI = 0. 526 - 0. 709 . Delong test showed that the predictive value of GNRI and PG- SGA GNRI and PNI were statistically significant Z= 3. 83 4. 85 P < 0. 001 . The indexes of PA ALB TP and HB before、1 day after and 3-5 days after the surgery of the malnourished patients were significantly lower P<0. 05 . In addition the incidence of surgical site infection SSI was also higher in malnourished patients χ 2 = 5. 03 P = 0. 036 . Conclusion GNRI has shown good applicability in the nutritional assessment of elderly patients with digestive system tumors. In addition GNRI may be able to predict a patient's perioperative nutritional status and short-term prognosis.
2024 Vol. 11 (2): 236-243 [Abstract] ( 59 ) HTML PDF (1958 KB)  ( 84 )
244 Changes of energy intake and three productive nutrients in patients with gastric cancer at different ages after partial gastrectomy
Kang Shuhong, Guli Sitan, Wang Tingting
Objective To analyze the changes of diet and nutrition intake in gastric cancer patients of different ages after gastrectomy. Method A total of 106 patients with partial gastric cancer who underwent gastrectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were selected and divided into 89 patients in the non-elderly group < 60 years old and 17 patients in the elderly group ≥60 years old . The intake of energy carbohydrate protein and fat before surgery 1 month and 3 months after surgery were compared between the two groups. And the decrease rate of energy carbohydrate protein and fat intake 1 month and 3 months after surgery. Result The intake of energy carbohydrate and fat in the non-elderly group was decreased one month after surgery P<0. 05 and the protein intake in the elderly group was decreased one month after surgery 64. 09±10. 85 g / d compared with that before surgery 71. 21±8. 76 g / d P<0. 05 . Fat intake 43. 55±8. 66 g / d and 46. 74± 9. 70 g / d in the elderly group at 1 and 3 months after surgery were lower than those before surgery 52. 45±6. 61 g / d P<0. 05 . Fat intake 49. 56±9. 82 g / d and 52. 88±10. 88 g / d in the non-elderly group was significantly higher than that in the elderly group 43. 55±8. 66 g / d and 46. 74±9. 70 g / d at 1 month and 3 months after surgery P<0. 05 . The decrease rate of protein and fat intake in non-elderly group was significantly lower than that in elderly group one month after operation P<0. 05 . Conclusion The damage to protein and lipid intake in elderly patients with gastric cancer undergoing gastrectomy is more significant compared to non elderly patients. This suggests that targeted dietary and nutritional guidance can be provided according to the patient's age in clinical treatment of gastric cancer or it can improve the patient's rehabilitation efficiency.
2024 Vol. 11 (2): 244-250 [Abstract] ( 73 ) HTML PDF (1146 KB)  ( 70 )
251 Effect of hospital - community - family - based nutrition management program on patients with head and neck cancer undergoing radiotherapy and chemotherapy
Ren Jiao, Liu Bo, Tang Yuanyuan
Objective To explore the impact of hospital - community - family - based nutritional management program on the nutritional status of head and neck cancer radiotherapy patients. Method 150 head and neck cancer patients who received radiotherapy in Jiangsu Provincial People's Hospital from February 2022 to March 2023 were selected as the study subjects and the patients were divided into the intervention group and the control group using the random number method with 75 patients in each group. The control group was given routine nutritional management and the intervention group was given a hospital-community-family-based nutritional management program and three months after the intervention the patients were evaluated using the patient-generated subjective global assessment PG-SGA nutritional risk screening NRS 2002 to assess the nutritional level of the two groups of patients and t-test / χ 2 test was used to compare the BMI total protein albumin complication rate and severity of the two groups of patients after admission to the hospital and the end of radiotherapy treatment. Result Total protein 67. 62±6. 09 g / L vs 61. 75±5. 28 g / L albumin 37. 78±4. 12 g / L vs 33. 17±3. 98 g / L prealbumin 214. 23±45. 19 g / L vs 191. 08±42. 58 g / L and lymphocyte count 1. 13± 0. 39 × 10 9 / L vs 0. 74± 0. 43 × 10 9 / L were higher than those in the control group P < 0. 05 the complication rate 30. 67% vs 54. 67% and severity 25. 33% vs 56. 67% 5. 33% vs 8. 00% were lower than those in the control group P < 0. 05 and the proportion of patients with low nutritional risk in the intervention group was higher than that in the control group 86. 67% vs 77. 33% P < 0. 05 and the proportion of patients with high nutritional risk was lower than that of the control group 13. 33% vs 22. 67% P < 0. 05 PG-SGA score 6. 98 ± 5. 17 points vs 7. 42 ± 4. 63 points and BMI 20. 93 ± 2. 74 kg / m 2 vs 19. 62 ± 2. 81 kg / m 2 were both better than that of the control group P<0. 05 . Daily energy intake for enteral nutrition was higher in the intervention group than in the control group after the intervention 691. 83±264. 29 kcal vs 348. 12±153. 28 kcal P< 0. 05 . Conclusion The hospital-community-family-based nutritional management program has a good intervention effect on patients with head and neck cancer radiotherapy which can significantly improve the nutritional status and severity of complications.
2024 Vol. 11 (2): 251-257 [Abstract] ( 61 ) HTML PDF (1296 KB)  ( 61 )
258 Qualitative study on exercise mental experience of cancer patients during intermittent chemotherapy rehabilitation at home
Han Xiaoxia, Han Fengxia, Chen Xiang, Liu Dan, Shi Xiaoxiao
Objective Analyze the psychological experience and real needs of cancer patients undergoing home rehabilitation exercise during chemotherapy intervals. Method Collect data from August 2022 to October 2022 at Nantong Cancer Hospital tumor patients who undergo multiple rounds of chemotherapy. Phenomenological research method was used to conduct qualitative research and in-depth interviews were conducted on 27 cancer patients who had undergone multiple chemotherapy through semi-structured interviews. Colaizzi analysis method was used to analyze sort out summarize and summarize the interview contents. Result The results showed that the home rehabilitation exercise for cancer patients during the chemotherapy interval mainly summarized six themes positive and negative emotions are present in patients with home rehabilitation exercises patients' misconceptions about rehabilitation exercise disease symptoms hindering home rehabilitation exercise high self-efficacy promoting home rehabilitation exercise the level of social support has an impact on the patient's rehabilitation exercise and patients' strong willingness to seek support. Conclusion Cancer patients have different cognition of rehabilitation exercise during the interval of chemotherapy at home and medical staffs pay little attention to the status of rehabilitation exercise during the interval of chemotherapy at home. Medical staff should strengthen related health education to improve the cognition level of rehabilitation exercise of patients and their families.
2024 Vol. 11 (2): 258-263 [Abstract] ( 65 ) HTML PDF (2208 KB)  ( 48 )
264 Digital twin for monitoring and predicting recurrence risk in colorectal cancer patients a clinical study protocol
1,2Tan Xin,3Luo Bin,4Chen Ningbo,5Wang Qi,2Jiang Hua
Background Colorectal cancer ranks among the top three most prevalent cancers worldwide posing a significant challenge despite surgical intervention. Detecting tumor recurrence early is paramount to improving the survival outcomes of patients post-colorectal cancer surgery. Presently recurrence prediction relies heavily on clinicians' subjective judgment drawing from clinical examination blood tests imaging and other clinical data. However this method lacks objective reliability and risks patients missing optimal intervention opportunities. While new diagnostic methods have emerged they are often costly and challenging to implement universally. Moreover they typically operate reactively detecting tumors only after significant in vivo development serving as a 􀆴 debriefing􀆶 mode. Method This study is based on retrospective cohort data collected from patients with colorectal cancer admitted to the Department of Gastrointestinal Surgery and Emergency Surgery at Sichuan Provincial People 's Hospital Affiliated Hospital of University of Electronic Science and Technology of China between January 2013 and October 2018. Stringent exclusion criteria will be applied during patient selection and clinical data from colon cancer patients are gathered spanning five years before and after surgery. The collected data will undergo thorough cleaning preprocessing classification and enrichment processes to create an AI-ready dataset. Leveraging a combination of data-driven and mechanistic modeling approaches we aim to develop a digital twin model capable of monitoring and predicting colorectal cancer recurrence within a five-year timeframe. Conclusion Current studies have shown that the recurrence rate of colorectal cancer five years after surgery is as high as 30% and a reliable tool for early warning of postoperative recurrence of colorectal cancer is urgently needed in clinic. Digital twin technology can realize multi-dimensional data processing establish multi -module model prediction and establish a prediction model with time series which is suitable for the prediction of colorectal cancer patients' recurrence. Based on digital twin technology this study intends to establish a prediction model of tumor recurrence in patients with colorectal cancer within 5 years after surgery in order to achieve the monitoring and early warning of tumor recurrence and reduce the mortality of patients with colorectal cancer recurrence after surgery.
2024 Vol. 11 (2): 264-269 [Abstract] ( 94 ) HTML PDF (2723 KB)  ( 172 )
270 Pharmacokinetic characteristics and clinical synergistic strategy of high-dose vitamin C against cancer
Wang Shiwan, Wang Xin, Qu Jinxiu, He Jia, Zhao Yuan, Rao Benqiang
High - dose vitamin C HDVC therapy has synergistic or sensitizing effects on chemotherapy radiotherapy and targeted therapy in preclinical experiments. However the clinical efficacy of HDVC is limited which shows that there is no significant improvement in the prognosis of cancer patients. This may be related to the pharmacokinetic characteristics of vitamin C such as Vitamin C is volatile that its half-life is only 30 minutes and is rapidly excreted through renal first-order kinetics also its effective concentration duration of only a few hours. Thus after stopping infusion the plasma vitamin C concentration rapidly decreases resulting in insufficient time for the drug to reach a peak concentration or maintain an effective concentration to kill tumor cells in the body. As a cheap and low-toxicity anti-tumor therapy HDVC needs to find strategies to enhance its clinical efficacy. This article summarizes the clinical efficacy enhancement strategies of HDVC from existing clinical trials by increasing blood concentrations prolonging effective concentration durations and delaying drug metabolism which including adjusting the solvent using sterile water as the preferred preparation preparing it on site and sealing it with vacuum standardizing the dosing schedule and recommending a single dose of 75-100 g 1. 5-2. 2 g / kg administered intravenously at a constant speed of 1g / min for at least 3 times per week for 4 weeks or longer. Nanotechnology and combining with arsenic trioxide or FOLFOX can also enhance the clinical efficacy of HDVC. These strategies provide ideas and references for the standardized clinical application of HDVC in the future.
2024 Vol. 11 (2): 270-275 [Abstract] ( 110 ) HTML PDF (3608 KB)  ( 113 )
276 Research on the status and strategies of rehabilitation management for pediatric oncology at home and abroad
Wang Jing, Liu Yun, Huang Haoyu, Wu Jinting, Zhang Yangping, Xu Shaoting
The number of pediatric cancer patients is increasing year by year and tumors seriously threaten the life and health safety of children. The influence of disease and treatment leads to the decline of physical quality and quality of life. With the continuous improvement of the survival rate of children more attention needs to be paid to the quality of life of these children during and after cancer treatment. The treatment of pediatric oncology requires frequent and invasive medical intervention. These have serious impacts on the child's daily life and quality of life so early and sustained rehabilitation is important to reduce disability and optimise function. The rehabilitation management of pediatric cancer patients should focus on the needs of pediatric cancer patients restore the dysfunction caused by tumor and tumor treatment as much as possible realize the comprehensive rehabilitation of various systems and help pediatric cancer patients to return to their families and society. Current treatment measures for children with severe oncology are relatively well mature but long - term follow- up and rehabilitation interventions are weak and a set of rehabilitation management programme for oncology children is urgently needed to improve their prognosis. Paediatric oncology rehabilitation requires comprehensive rehabilitation programme which should include dedicated multidisciplinary team. Therefore this paper reviews the current status and strategies of rehabilitation intervention for pediatric oncology at home and abroad in order to improve the daily living ability and quality of life of them.
2024 Vol. 11 (2): 276-282 [Abstract] ( 85 ) HTML PDF (2929 KB)  ( 82 )
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