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2024 Vol. 11, No. 3
Published: 2024-06-09
 
283 Fructose intake and tumors what can we learn from them?
Tong Ning, Xu Hongxia
Fructose a common monosaccharide is predominantly utilized in the form of high fructose corn syrup. The increasing prevalence of chronic metabolic disorders such as obesity diabetes and hyperlipidemia has been linked to the widespread consumption of high fructose corn syrup. Moreover this dietary trend has been recognized to create a conducive metabolic milieu for tumor growth. While direct evidence establishing a causal relationship between fructose intake and tumorigenesis in humans remains sparse a growing body of epidemiological and experimental research has identified a strong association between high fructose consumption and the initiation and progression of tumors. This study aims to enhance our comprehension of the metabolic pathways and properties of fructose in tumor cells to elucidate experimental proof of the connection between fructose and tumor development and to offer scientifically-backed dietary recommendations for both healthy individuals and cancer patients. By doing so this investigation aims to serve as a valuable resource for the prevention and treatment of tumors.
2024 Vol. 11 (3): 283-289 [Abstract] ( 119 ) HTML PDF (5488 KB)  ( 73 )
290 The role and consideration of nurses in the management of home enteral nutrition of cancer patients
1Guo Miaomiao,2Chen Yongyi
Home enteral nutrition refers to the delivery of nutrient solution through the gastrointestinal tract to patients with stable conditions but unable to meet their nutritional needs. It can improve the nutritional status of patients and enhance their quality of life and is an important component of nutritional support for cancer patients. Patients and caregivers are important implementers of home enteral nutrition but often experience energy intake failure or interruption of enteral nutrition due to improper operation insufficient awareness of complications and other issues. Long-term monitoring and management by nutrition support teams are needed. Although there is evidence-based medicine to provide reference for home enteral nutrition management of cancer patients localized practical verification is still needed. As an important member of the team managing home enteral nutrition for cancer patients nurses play the role of coordinating communicators educators researchers and ethical decision - makers thereby promoting communication and coordination among teams strengthening patient health education and ensuring the smooth progress of home enteral nutrition management for cancer patients. This article delves into the concept and essence of home enteral nutrition emphasizing the role and considerations of nurses in managing home enteral nutrition aiming to offer insights for nurses to better contribute to the management of home enteral nutrition for cancer patients.
2024 Vol. 11 (3): 290-294 [Abstract] ( 111 ) HTML PDF (897 KB)  ( 35 )
295 Nutrition prescription
1Yang Yun,1Wang Yixuan,2Shi Hanping
Prescription refers to a medical document issued and verified by relevant qualified professionals. They serves as a voucher for the patient's medication. Its current management is mainly based on the Prescription Management Measures. Prescription is a written document of medication for patients. Pharmacy staff relies on prescriptions to deploy medicines and the prescription holds legal technical and economic responsibilities. Prescription mainly contains three parts the prenote the main text and the postnote to the prescription. The prescription should contain the full name of the hospital the department the patient's name gender age date the name of the drug dosage specifications quantities and usage and the formal prescription should be signed by the prescribing physician and an auditor. At present the Prescription Management Measures do not categorize prescriptions and the current prescriptions refer specifically to drug prescriptions. This paper summarizes the basic elements and requirements of nutritional prescriptions based on the basic principles of nutritional therapy combined with prescription specifications in order to provide guidance for clinical work in prescribing nutritional prescriptions.
2024 Vol. 11 (3): 295-299 [Abstract] ( 154 ) HTML PDF (1890 KB)  ( 66 )
300 The endogenous ω-6 / ω-3 ratio an important factor influencing the health effects of ω-3 PUFAs
1Zou Bo,2Kang Jingxuan,1 2Wang Bin
ω-3 polyunsaturated fatty acids PUFAs are essential structural and functional nutrients in humans with numerous studies demonstrating their lipid - lowering anti - inflammatory cardiovascular protective and tumor microenvironment - improving effects. However the inconsistent results from ω-3 PUFAs intervention trials hinder their widespread application in medical guidelines and limit their clinical use in disease management. As another class of polyunsaturated fatty acids ω-6 PUFAs are commonly found in excess in global diets leading to an imbalance in the ω- 6 / ω- 3 ratio and potentially impeding the health effects of ω- 3 PUFAs. Research has shown that high ω-6 / ω-3 ratios may hinder the beneficial effects of ω-3 PUFAs and are closely associated with the development of numerous chronic diseases due to cellular membrane structure competition and metabolic interference between ω-6 and ω-3 PUFAs. This review analyzes the interaction between ω-3 and ω-6 PUFAs in the body and highlights the importance of the ω-6 / ω-3 ratio in modulating the effects of ω-3 PUFAs. Furthermore it emphasizes that the oversight of the ω-6 / ω-3 ratio in previous ω-3 PUFAs studies may be a key reason for inconsistent results suggesting the need to standardize research protocols and include the ω-6 / ω-3 ratio as a quality control parameter to objectively elucidate the health effects of ω-3 PUFAs and promote their standardized application in disease management.
2024 Vol. 11 (3): 300-307 [Abstract] ( 102 ) HTML PDF (2516 KB)  ( 35 )
308 Nutritional therapy is the basic treatment and first-line treatment of diseases
1Guo Shubin,2Ruan Guotian,3Shi Hanping
Nutritional therapy is a basic right of human beings and it is the responsibility of medical services to apply nutritional therapy to clinical work. Nutritional therapy is the first-line treatment nutrition is the basis of rehabilitation of all diseases is the cornerstone of human self-healing and anti-injury. As an independent treatment nutritional therapy can not only provide patients with the energy and nutrients needed for disease recovery but also shorten hospital stay reduce complications improve the cure rate and mortality of the disease and have a synergistic effect with other treatments. In terms of medical economic benefits nutritional therapy can reduce the use of medical resources and medical costs and bring economic benefits to the health care system. The nutritional therapy of patients should run through all the time start early detect the whole process and return the nutritional and nourishing foundation of the patients.
2024 Vol. 11 (3): 308-313 [Abstract] ( 118 ) HTML PDF (927 KB)  ( 99 )
314 Expert consensus on home enteral nutrition care for cancer patients
Chinese Society of Nutritional Oncology
The incidence rate of malnutrition in cancer patients is high. Standardized and effective nutrition treatment is conducive to improving the quality of life of patients shortening the length of hospital stay and improving the survival rate. Home enteral nutrition is an important extension of in -hospital nutrition support and should be considered if the type and quantity of nutrients consumed by patients are less than a week or longer. In the process of implementing enteral nutrition at home patients often experience energy failure or interruption of enteral nutrition due to insufficient nutrient intake or serious complications. Therefore timely and professional guidance and monitoring are particularly important such as the use of enteral nutrition access equipment the use and storage of enteral nutrition preparations and the identification and management of complications. This article takes the latest guidelines on home enteral nutrition management at home and abroad as a reference searches for various studies published in recent years such as randomized controlled trials systematic evaluations and meta - analyses and combines clinical experience to summarize and recommend the best care mode screening and evaluation program implementation nutrition education and other aspects of home enteral nutrition care for cancer patients providing a basis for the standardization and standardization of clinical nursing.
2024 Vol. 11 (3): 314-321 [Abstract] ( 134 ) HTML PDF (1000 KB)  ( 53 )
322 Expert consensus on micronutrients deficiency and supplementation in malignant tumors
The Radiation Therapy Integrated Nursing Committee of Chinese Anti-Cancer Association, The Oncologic Nutritional Nursing Committee
Micronutrients including trace elements and vitamins are substances that the human body needs in small quantities but are necessary to involve in normal physiological process of organism. Malignant tumor as a chronic wasting disease is one of the major challenges in today's world. Patients with malignant tumors is a high-risk group for malnutrition and the 2019 report of the Chinese Society of Nutritional Oncology CSNO shows that the incidence of malnutrition in China's tumor patients is as high as 58%. Nutritional support for malignant tumor patients during therapy has been generally recognized. However as a part of nutrients the importance of micronutrients in malignant tumor patients has not yet attracted widespread attention. Micronutrient deficiencies will affect tumor development make patients tolerance to antitumor therapy decreased increase adverse reactions negatively affect quality of life and shorten patient survival period. The practice of micronutrient supplementation is subject to much controversy and uncertainty due to factors such as tumor type treatment regimen and individual differences. Therefore this consensus organizes interdisciplinary collaboration among medical nutritional and nursing parties based on existing domestic and international studies demonstrates the impact of micronutrient deficiencies on patients with malignant tumors. We also summarize and recommend measurements assessments and supplementation treatments of micronutrient for malignant tumors patients which satisfy the nutritional needs.
2024 Vol. 11 (3): 322-331 [Abstract] ( 168 ) HTML PDF (1503 KB)  ( 146 )
332 Prognostic value of skeletal muscle density change of L3 vertebra in patients with esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy
1Nie Xinyu,2Yang Ningjing,2Lyu Jiahua,2Liu Yudi,1 2Li Tao
Objective To investigate the correlation between skeletal muscle density SMD of L radiotherapy and prognosis of esophageal squamous cell carcinoma ESCC . Method This study was a 3 re v t e r r o t s e p b e r c a tiv b e efo c r a e se and after study of patients diagnosed with esophageal squamous cell carcinoma between March 2012 and November 2018. The skeletal muscle density of L3 cone skeletal muscle area of L3 cone subcutaneous fat area of L3 cone and visceral fat area of L3 cone were measured before and after radiotherapy. Hazard ratios were used to assess the association between changes in SMD and overall survival OS before and after radiotherapy. Kaplan-Meier curve and Cox proportional risk model were used for survival analysis. Result Among 258 patients with esophageal squamous cell carcinoma 162 patients in the L3 pyramidal subcutaneous skeletal muscle density increase group after radiotherapy were followed for a median of 22. 4 months ranging from 3. 3 to 92. 4 months . Through univariate Cox proportional risk analysis we found that changes in SMD age ≥60 years and tumor length after radiotherapy were independent prognostic factors affecting overall survival P< 0. 05 . Conclusion Changes in subcutaneous skeletal muscle density before and after radiotherapy can be used as a prognostic biomarker for overall survival in ESCC patients.
2024 Vol. 11 (3): 332-338 [Abstract] ( 103 ) HTML PDF (2177 KB)  ( 68 )
339 Risk factors analysis of cancer induced fatigue in elderly patients with lung cancer undergoing chemotherapy
Xiang Kemei, Luo Tian, Li Panpan
Objective To investigate and analyze the incidence and risk factors of chemotherapy induced fatigue in elderly lung cancer patients. Method 120 elderly lung cancer patients admitted to our hospital from March 2020 to March 2023 were selected as the survey subjects. All patients received unified chemotherapy treatment and were evaluated using the Piper fatigue scale. The number of patients with cancer induced fatigue was counted and the incidence of fatigue was calculated. According to the occurrence of fatigue in patients they were divided into a fatigue group and a normal group and the risk factors of cancer induced fatigue in elderly lung cancer patients undergoing chemotherapy were analyzed using univariate and multivariate logistic regression. Result Out of 120 elderly lung cancer patients 79 patients experienced cancer induced fatigue fatigue with an incidence rate of 65. 83%. The patients were divided into a fatigue group 79 cases and a normal group 41 cases . Univariate analysis showed that the age tumor stage basic disease history and incidence of complications of the fatigue group were higher than those of the normal group while serum albumin ALB was lower than that of the normal group P < 0. 05 . Multivariate analysis shows that advanced age high tumor staging comorbidities with underlying diseases complications and low ALB are independent risk factors for cancer related fatigue in elderly patients with lung cancer undergoing chemotherapy. Conclusion Elderly lung cancer patients generally experience cancer induced fatigue symptoms during chemotherapy among which advanced age high tumor staging comorbidities with underlying diseases complications and low ALB are independent risk factors for the occurrence of cancer induced fatigue.
2024 Vol. 11 (3): 339-343 [Abstract] ( 58 ) HTML PDF (885 KB)  ( 47 )
344 Summary of the best evidence for home enteral nutrition care for oncology patients
1Sun Lulu,2Chen Yongyi,1Dong Shan,1Guo Miaomiao,1Yuan Ling
Objective To retrieve evaluate and summarize the best evidence on home enteral nutrition care for oncology patients at home and abroad and to provide a reference basis for implementing home enteral nutrition care. Method This study conducted a systematic search of PubMed Up To Date The Cochrane Library National Institute for Health and Clinical Excellence NICE Registered Nurses' AssoCiation of Ontario RNAO MedLive Clinical Guidelines China Knowledge Network Wanfang Database VIP and other databases. Registered Nurses' AssoCiation of Ontario RNAO Clinical Guidelines China Knowledge Network Wanfang Database and VIP etc. We conducted a systematic search to comprehensively retrieve evidence on home enteral nutrition care for oncology patients and selected clinical evidence based on the "6S" evidence pyramid model. Based on the "6S" evidence pyramid model we selected clinical decisions guidelines systematic evaluations/ Meta - analyses evidence summaries expert consensus randomized controlled trials and so on. The time frame of the search was from December 1 2013 to December 1 2023 and was based on the "6S" evidence pyramid model. Literature quality assessment and data extraction were performed independently by 2 persons with evidence-based professional background. Result A total of 23 publications were included including 8 guidelines 4 expert consensus 3 evidence summaries 6 systematic evaluations and 2 randomized controlled studies. Twenty-two pieces of best evidence were summarized in 4 areas including optimal care team screening and assessment implementation and evaluation and nutrition education for home enteral nutrition care in oncology patients. Conclusion This study provides evidence-based evidence for home enteral nutrition care for oncology patients thereby improving the quality of nutritional management for oncology patients.
2024 Vol. 11 (3): 344-352 [Abstract] ( 87 ) HTML PDF (1026 KB)  ( 44 )
353 Initial exploration of predicting sarcopenia in colorectal cancer based on mid - upper arm circumference and calf circumference
1Liao Xin,1Su Wenyi,1Jiang Qilan,1Han Ming,2Lyu Muhan,1Wang Min
Objective To investigate the predictive value of mid-upper arm circumference MAC and calf circumference CC for sarcopenia in patients with colorectal cancer CRC . Method This is a cross-sectional study that includes 372 patients who were diagnosed with CRC for the first time at the Department of Gastrointestinal Surgery Affiliated Hospital of Southwest Medical University from April 2022 to August 2023 with appendicular skeletal muscle mass ASM and appendicular skeletal muscle mass index ASMI measured by bioelectrical impedance analysis BIA and MAC CC hand grip strength and 6-Meter Walk test measured with comparison of basic conditions by grouping by sarcopenia. Grouped by gender ROC curves were used to compare the predictive value of MAC and CC for sarcopenia in patients with CRC and to determine the optimal cut-off value and Kappa values were calculated to determine the consistency of MAC and CC with the diagnostic criteria for sarcopenia. Result Among 372 CRC patients 233 62. 6% were male and 139 37. 4% were female and 81 21. 8% were diagnosed with sarcopenia. The ROC curves showed that the optimal cut-off values for MAC to predict sarcopenia were 24. 9 cm in males sensitivity 81. 8% specificity 73. 0% and 23. 7 cm in females sensitivity 80. 8% specificity 72. 6% and for CC to predict the best cut - off values for sarcopenia were 32. 4 cm sensitivity 74. 5% specificity 80. 9% in men and 31. 0 cm sensitivity 88. 5% specificity 66. 4% in women. The AUC values of MAC CC and the combination of the two for the prediction of sarcopenia were 0. 824 0. 851 0. 864 for male patients and 0. 819 0. 801 0. 828 for female patients respectively which showed a higher value of the combined one. Comparing with the diagnostic criteria of sarcopenia the Kappa values of MAC and CC were 0. 443 0. 493 for male and 0. 385 0. 334 for female respectively. Analysis by gender age history of smoking alcohol consumption clinical stage and body mass index BMI subgroups revealed that mPG-SGA showed strong consistency for good/ mild malnutrition moderate malnutrition and severe malnutrition among patients with BMI<18. 5 kg / m 2 Kappa=0. 762 P=0. 001 . All subgroups with the exception of BMI<18. 5 kg / m 2 showed almost perfect consistency for the three different nutritional stages Kappa>0. 9 P<0. 001 . Conclusion Both MAC and CC have good predictive value for sarcopenia in patients with CRC and the combination of them has a better predictive effect.
2024 Vol. 11 (3): 353-359 [Abstract] ( 57 ) HTML PDF (1509 KB)  ( 85 )
360 The modified patient-generated subjective global assessment can be used for the assessment of malnutrition in patients with primary liver cancer
1Su Wenyi,2Li Bo,1Jiang Qilan,1Han Ming,1Liao Xin,1Wang Min
Objective To evaluate the nutritional status of patients with primary liver cancer and to compare the ability of PG-SGA and mPG-SGA to assess malnutrition. Method Clinical data of 249 patients diagnosed with primary liver cancer for the first time at Affiliated Hospital of Southwest Medical University between April 2022 and September 2023 were collected. PG-SGA and mPG-SGA were used to assess the nutritional status of patients. Spearman correlation analysis was used to compare the correlation between different nutritional indicators and two scales. The ROC curve was used to evaluate the accuracy of mPG-SGA. The Kappa coefficients were used to evaluate the concordance between two scales. Result Among 249 patients with primary liver cancer 196 78. 71% and 189 75. 90% were diagnosed with moderate to severe malnutrition using PG - SGA and mPG - SGA respectively. Using PG-SGA as a criterion mPG-SGA showed good accuracy for good / mild malnutrition moderate malnutrition and severe malnutrition with AUC values of 0. 982 0. 938 and 0. 977 respectively P < 0. 001 . It also showed almost perfect consistency with PG-SGA Kappa = 0. 951 P<0. 001 . Analysis by gender age history of smoking alcohol consumption clinical stage and body mass index BMI subgroups revealed that mPG-SGA showed strong consistency for good / mild malnutrition moderate malnutrition and severe malnutrition among patients with BMI < 18. 5 kg / m 2 Kappa = 0. 762 P = 0. 001 . All subgroups with the exception of BMI<18. 5 kg / m 2 showed almost perfect consistency for the three different nutritional stages Kappa>0. 9 P<0. 001 . Conclusion Malnutrition is prevalent in patients with primary liver cancer. mPG-SGA has been shown to have good accuracy and concordance with PG-SGA. It is a simpler tool for assessing malnutrition in patients with primary live cancer.
2024 Vol. 11 (3): 360-366 [Abstract] ( 81 ) HTML PDF (944 KB)  ( 26 )
367 Prognostic value of patient - generated subjective global assessment for colorectal cancer patients and construction of a nomogram
Zhao Dong, Xu Jianhua, Ji Peidong, Ming Zhixiang
Objective To investigate the prognostic value of patient - generated subjective global assessment PG - SGA for colorectal cancer patients and construct a nutrition - related nomogram integrated with nutritional status with clinicopathologic parameters for survival prediction. Method A retrospective analysis was conducted on 202 colorectal cancer patients who underwent curative resection in Nantong Affiliated Hospital of Nanjing University of Chinese Medicine from January 2016 to January 2020. Preoperative nutritional status was evaluated by PG-SGA and its impact on overall survival OS of colorectal cancer patients was analyzed. The univariate and multivariate Cox regression analysis was used to determine independent prognostic factors. A nomogram model was constructed and its predictive performance was tested by the consistency index C-index and calibration plots. Result According to the PG-SGA 33. 7% of patients had moderate malnutrition and 26. 7% were severely malnourished. Patients with severe malnutrition had a larger tumor diameter P = 0. 044 and a lower proportion of adjuvant chemotherapy following the surgery P = 0. 029 than other patients. The 5-year OS rates of patients with well nutrition moderate malnutrition and severe malnutrition were 81. 6% 63. 2% and 46. 5% respectively. There were significant survival differences between the groups P< 0. 05 . Tumor size P= 0. 046 pT stage P= 0. 002 lymph node metastasis P = 0. 001 vascular invasion P<0. 001 and PG-SGA P<0. 001 were independent prognostic factors for colorectal cancer patients. A nomogram model was developed according to the above prognostic parameters and its C-index was 0. 781 95% CI = 0. 671 - 0. 890 . The calibration plots showed a good consistency between the predicted survival probability and actual survival probability. Conclusion PG-SGA is a useful tool for survival prediction of colorectal cancer patients and it might further optimize the prognostic risk stratification of patients along with clinicopathologic parameters.
2024 Vol. 11 (3): 367-374 [Abstract] ( 51 ) HTML PDF (1379 KB)  ( 27 )
375 The effect of enteral nutrition combined with accelerated rehabilitation for non-small cell lung cancer∗
Huang Ping, Xing Shijiang, Xie Xiaoping, Ji Jinfeng
Objective Analyze the effectiveness of enteral nutrition combined with accelerated rehabilitation for non-small cell lung cancer patients undergoing surgery based on the DEA model. Method 102 non -small cell lung cancer surgical patients treated at Xiaolan People's Hospital in Zhongshan City from October 2020 to October 2023 were selected and randomly divided into two groups using a random number table method. The control group 51 cases received routine intervention guidance while the experimental group 51 cases received enteral nutrition combined with accelerated rehabilitation. After comparing the intervention effects of the two groups the DEA model was used to predict the technical benefits TE scale benefits SE k and comprehensive benefits OE of the two groups θ 、 The coefficient of return to scale effectiveness and types of return to scale. Result Bedtime chest tube retention time antibiotic duration and hospital stay were shorter than controls P<0. 05 total treatment cost was less P<0. 05 functional status emotional status family status physiological status and lung cancer were higher P<0. 05 FEV 1 MVV FVC Hb ALB and TP were 7 d P<0. 05 and postoperative pulmonary complications 3. 92% vs. 17. 65% were lower than controls χ 2 = 4. 993 P= 0. 025 . At the same time the DEA model was established to predict that there were 32 decision units with technical benefit value of 1 in the test group and 28 comprehensive benefits mainly DEA was mainly effective and the scale was fixed in remuneration. The technical benefits and comprehensive benefits of the two groups were different and the technical benefits comprehensive benefits and scale remuneration coefficient of the pulmonary function indicators were different P< 0. 05 . Conclusion Based on the DEA model evaluation analysis the combination of enteral nutrition and accelerated rehabilitation can improve scale efficiency and comprehensive benefits with high utilization value. Its application in non-small cell lung cancer surgery patients has significant effects improving postoperative lung function and nutritional status reducing postoperative pulmonary complications and promoting postoperative rehabilitation
2024 Vol. 11 (3): 375-381 [Abstract] ( 46 ) HTML PDF (941 KB)  ( 27 )
382 Value of geriatric nutritional risk index as prognostic marker in elderly patients undergoing surgery for early lung cancer
1Tang Hong,2Yuan Dan
Objective To explore the value of geriatric nutritional risk index as a prognostic marker for early lung cancer patients and the construction of a decision tree prediction model. Method The retrospective analysis of 138 patients with early lung cancer were collected in West China Hospital from January 2021 to December 2022 and divided into two groups according to the prognosis of patients namely poor prognosis n = 21 and good prognosis n = 117 . Comparing the general data binary Logistic regression analysis and decision tree analysis affected the prognosis independent factors and the model was verified internally using Bootstrap method. Result The GNRI of patients with good prognosis was higher than that of patients with poor prognosis P<0. 05 . According to binary logistic regression analysis age ≥ 75 years old pleural involvement preoperative anemia history and GNRI value ≤ 97. 35 were independent factors affecting the prognosis of early lung cancer surgery P< 0. 05 . At the same time using four statistically significant variables from single factor analysis as predictive factors a decision tree model was constructed using SPSS software. Among them age was the main factor and the detected predictive value was 91. 1% Mainly involving pleura with a predicted detection value of 88. 6% Based on a history of preoperative anemia the predicted detection value is 90. 5% Based on GNRI values the predicted detection value is 73. 2%. The model was internally validated using Bootstrap. Result To simulate discrimination with an AUC of 0. 872 and a 95%CI of 0. 805-0. 938. According to the ROC curve model analysis the GNRI area plot is 0. 903 with a 95%CI of 0. 842-0. 963 a sensitivity of 90. 5% and a specificity of 79. 5%. Conclusion The nutritional risk index can predict the prognosis of early lung cancer patients undergoing surgery and the prognosis is also influenced by the patient ' s age pleural involvement and preoperative anemia history. By establishing a decision tree model that is easy to operate and visually effective the prognosis can be predicted as early as possible providing scientific basis for treatment plan formulation and prognosis evaluation.
2024 Vol. 11 (3): 382-389 [Abstract] ( 52 ) HTML PDF (2972 KB)  ( 38 )
390 Effects of enteral nutrition on cancer cell shedding flora and immunity in patients with colorectal cancer
Zhang Fujie, Zhang Wenjun, Yu Dengfeng
Objective To investigate the effects of enteral nutrition on cancer cell shedding intestinal flora and immune function in patients with colorectal cancer. Method A total of 300 patients with colorectal cancer who underwent radical surgery in Xinhua Hospital Affiliated to Dalian University from March 2022 to March 2023 were selected as the study objects and were divided into experimental group given enteral nutrition and control group given traditional intestinal preparation according to random number table method with 150 cases each. The positive rate of exfoliated cells in abdominal cavity and intestinal cavity intestinal tolerance and intestinal cleanliness were compared. The intestinal flora bifidobacterium lactobacillus Escherichia coli enterococcus total protein TP prealbumin PA albumin ALB CD4 + CD8 + were observed before and 7 days after surgery and the CD4 + / CD8 + ratio was calculated. Result The positive rates of exfoliated cells in abdominal cavity and intestinal cavity of experimental group were 4. 67% and 10. 67% respectively which were significantly lower than those in control group P<0. 05 . The overall intestinal tolerance Grade Ⅰ/ Ⅱ/ Ⅲ and intestinal cleanliness GradeⅠ/ Ⅱ/ Ⅲ/ Ⅳ between the two groups were statistically significant P < 0. 05 . The quantity of bifidobacterium and lactobacillus was higher than that before operation but the quantity of Escherichia coli and enterococcus was lower than that before operation P<0. 05 . The levels of CD4 + CD8 + CD4 + / CD8 + TP PA and ALB in experimental group were higher than those before surgery P< 0. 05 . The levels of bifidobacterium lactobacillus Escherichia coli Enterococcus CD4+,CD8 + CD4 + / CD8 + TP PA and ALB were 7. 65±0. 68 log GFU/ g 8. 56±1. 45 log GFU/ g and 8. 28±0. 97 log GFU/ g 41. 03±2. 21 % 26. 25±2. 07 % 1. 92±0. 28 69. 52±6. 82 g / L 266. 36±9. 58 mg / L 40. 01±3. 69 g / L The control group was 6. 19±0. 42 log GFU/ g 6. 08±0. 43 log GFU/ g 9. 31±1. 72 log GFU/ g 9. 01±1. 21 log GFU/ g 30. 14±1. 48 % 18. 01±1. 51 % 1. 50±0. 19 62. 01±4. 05 g / L 217. 08±8. 41 mg / L 31. 82±3. 12 g / L compared between the two groups Bifidobacterium lactobacillus CD4 + CD8 + CD4 + / CD8 + TP PA ALB were higher in experimental groups and Escherichia coli and Enterococcus were lower the difference was statistically significant P<0. 05 . Conclusion Preoperative enteral nutrition in patients with colorectal cancer is beneficial to reduce the positive rate of cancer cells shed in abdominal cavity and intestinal cavity correct gastrointestinal flora improve nutritional status and immune function and is of great significance for guiding clinical treatment and improving prognosis.
2024 Vol. 11 (3): 390-395 [Abstract] ( 54 ) HTML PDF (919 KB)  ( 45 )
396 Effect of medical custom diet on nutritional status and quality of life in patients with metastatic lung cancer
1Lu Ying,1Liu Liu,1Yang Sisi,1Han Huimin,1Shu Wenwen,2Xu Jianqun
Objective To explore the effects of medical customized diet HDMTM on nutritional status fatigue and quality of life in patients with metastatic lung cancer. Method A prospective selection of 108 patients with metastatic lung cancer admitted to Wuhan Third Hospital between June 2021 and June 2023 was conducted. They were randomly divided into two groups using a random number table method. The control group 54 cases received routine nutritional support while the intervention group 54 cases received HDMTM support. After intervention the nutritional status of the two groups serum albumin ALB total protein TP hemoglobin Hb lung function forced expiratory volume in one second FEV1 forced vital capacity FVC maximum ventilation volume per minute MVV cancer - related fatigue score and lung cancer specific quality of life assessment FACT - L score were compared. Result After 14 days of intervention the nutritional status and lung function of the two groups of patients improved compared to before treatment. The cancer-related fatigue score decreased and the FACT-L score increased with statistical significance P<0. 05 . After 14 days of intervention the improvement of FEV1 92. 84 ± 4. 52 % MVV 91. 29 ± 5. 45 L/ min FVC 3. 55 ± 0. 39 L Hb 111. 12 ± 6. 57 g / L ALB 43. 11 ± 4. 58 g / L and TP 69. 78 ± 3. 16 g / L in the intervention group was better than that in the control group with statistical significance P<0. 05 . The scores of emotional fatigue 4. 85 ± 1. 22 behavioral fatigue 3. 13 ± 1. 52 physical fatigue 3. 38 ± 1. 19 and cognitive fatigue 3. 15 ± 1. 14 after 14 days of intervention were lower than those of the control group with statistical significance P< 0. 05 . The FACT-L score 82. 85 ± 5. 25 and FACT-L score 93. 35 ± 4. 25 after 7 days of intervention were higher than those of the control group with statistical significance P< 0.05. Conclusion HDMTM is more targeted and scientific. Compared to conventional nutritional support it has a more significant effect in patients with metastatic lung cancer. It can not only improve lung function and nutritional status promote disease recovery but also alleviate fatigue improve quality of life and have higher utilization value.
2024 Vol. 11 (3): 396-401 [Abstract] ( 53 ) HTML PDF (922 KB)  ( 41 )
402 Effects of vitamin C and heat treatment on the proliferation of lung cancer A549 cells via PI3K/ AKT/ HIF-1α pathway
Du Yanping, Ou Junwen, Liu Manting, Lu Zhitong, Wu Xiaofeng
Objective To investigate the effects of vitamin C and heat treatment on lung cancer A549 cells and the related mechanisms. Method Different concentrations of vitamin C The final concentration is 0 1 2 4 8 mmol / L 0 1 2 4 8 mmol / L and different temperatures 37 ℃ and 41 ℃ were applied to A549 cells. CCK8 assay was used to detect the cell activity and FRASC Vitamin C assay Kit II was used to detect the concentration of vitamin C in the cells. Then A549 cells were divided into control group 37 ℃ 0 mmol / L vitamin C vitamin C group 37 ℃ 8 mmol / L vitamin C heat treatment group 41 ℃ 0 mmol / L vitamin C and combined group 41 ℃ 8 mmol / L vitamin C after 24 hours of intervention 2-NBDG was used to detect glucose uptake of A549 cells. The expression levels of GLUT1 GLUT3 PI3K AKT p-PI3K p-AKT and HIF-1α were detected by Western Blot assay. The results were statistically analyzed by ANOVA and LST-t test. Result The cell viability of A549 decreased with the increase of vitamin C intervention concentration P<0. 05 and the cell viability of 41 ℃ heat treated cells was lower than 37 ℃ after vitamin C intervention. P < 0. 05 . The intracellular vitamin C level increased with the increase of intervention concentration and the intracellular vitamin C level of 41 ℃ heat treated cells was lower than 37 ℃ after 2 4 and 8 mmol / L vitamin C intervention. P< 0. 05 . After the intervention compared to the control group the intracellular glucose intake of vitamin C group heat treatment group and combined group was decreased P<0. 05 and the heat treatment group was lower than the vitamin C group P<0. 05 and the combined group was lower than the vitamin C group and heat treatment group P < 0. 05 . Western Blot results showed that the expression levels of GLUT1 PI3K P-PI3K p-AKT in the three intervention groups and GLUT3 HIF-1α in the vitamin C group,and GLUT3 HIF-1α and AKT in the combined group were lower than those in control group P<0. 05 . The protein expression levels of GLUT1 PI3K p-PI3K in the combined group were lower than those in the vitamin C group P< 0. 05 and GLUT3 AKT P-PI3K and HIF-1α in the combined group were lower than those in the vitamin C group and the heat treatment group P<0. 05 . Conclusion Compared with vitamin C or 41 ℃ heat treatment vitamin C combined heat treatment significantly inhibited the PI3K/ AKT/ HIF-1α pathway of A549 cells down-regulated GLUT1 and GLUT3 reduced intracellular glucose uptake and inhibited A549 cell proliferations.
2024 Vol. 11 (3): 402-407 [Abstract] ( 48 ) HTML PDF (4545 KB)  ( 35 )
408 Construction and verification of risk prediction model of radiation esophagitis in patients with esophageal cancer
Zhang Yu, Dong Xue
Objective To explore the establishment of a risk nomogram prediction model for radiation esophagitis in patients with esophageal cancer. Method A total of 94 patients with esophageal cancer who underwent radiation therapy in Department of VIP Medical Services of the Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College from October 2017 to July 2022 were selected as the study objects. They were divided into two groups according to whether radiation esophagitis occurred during follow-up including 53 patients in the radiation esophagitis group and 41 patients in the non -radiation esophagitis group. Multivariate Logistic regression analysis was used to screen the independent risk factors of radiation esophagitis in patients with esophageal cancer and the nomogram model was established on this basis. Result There were statistically significant differences in surgical conditions nutritional support tumor location TNM stage and hypoproteinemia between radiation esophagitis group and non-radiation esophagitis group P< 0. 05 . Multivariate Logistic regression analysis showed no surgery OR = 3. 152 95% CI = 1. 070-4. 471 no nutritional support OR = 2. 330 95%CI = 1. 268-3. 544 tumor location in the neck OR = 3. 380 95% CI = 1. 197- 10. 551 and TNM stage ≥ Ⅲ OR = 2. 625 95% CI = 1. 387 - 5. 554 were independent risk factors for radiation esophagitis. Based on the results of multivariate Logistic regression analysis a nomogram prediction model was established and receiver operating characteristic curve ROC was used to evaluate the prediction efficiency of radiation esophagitis. The results showed that the area under the curve AUC was 0. 730. Conclusion Radiation esophagitis may occur in some patients with esophageal cancer after radiotherapy. The independent risk factors for radiation esophagitis include no operation no nutritional support neck location of the tumor and TNM stage ≥Ⅲ. The establishment of a quantitative nomogram prediction model based on the above risk factors has good efficacy and clinical application value.
2024 Vol. 11 (3): 408-413 [Abstract] ( 74 ) HTML PDF (966 KB)  ( 30 )
414 Association of FOXP3 + tumor infiltrating lymphocytes with poor prognosis of primary breast cancer a retrospective cohort study
Zhao Xia, Li Yanping, Feng Yu, Lyu Shuzhen
Objective To detect the expression of FOXP3 + TILs in primary invasive breast cancer analyze the correlation between the expression level of FOXP3 + TILs and the clinicopathological characteristics of breast cancer and explore the relationship between FOXP3 + TILs and the prognosis of breast cancer. Method Surgically resected samples from 156 patients with invasive breast cancer BC were assessed for the expression of FOXP3 + TILs and CD4 + TILs by immunohistochemistry. The correlation between FOXP3 + TILs and the patients ' clinicopathological characteristics was explored. Kaplan - Meier survival analysis and Cox proportional hazards regression model were used to assess the correlation between FOXP3 + TILs and breast cancer-specific survival and to stratify the evaluation of breast cancer subtypes. Result Elevated FOXP3 + TILs infiltration were significantly correlated with high histological grade P= 0. 021 positive human epidermal growth factor receptor-2 HER-2 P=0. 018 Progesterone receptor expression PR P=0. 016 high Ki-67 index P = 0. 042 and axillary lymph node metastases P = 0. 001 . There was no significant correlation between CD4 + TILs expression and the clinicopathological features of all patients. Tumors with concomitant high expressions of FOXP3 + TILs had worse overall survival OS and disease-free survival DFS 64. 7% vs 87. 6% χ 2 = 15. 3 P<0. 001 56. 9% vs 80. 0% χ 2 = 13. 1 P<0. 001 . The patients with axillary lymph node metastases with the high expressions of FOXP3 + TILs infiltration had worse DFS P<0. 001 . Multivariate analysis showed that FOXP3 + TILs was independent predictors of OS HR=2. 732 95%CI=1. 174~6. 207 P=0. 023 and DFS HR=2. 092 95%CI= 1. 068~4. 088 P = 0. 032 . Conclusion The high expression of FOXP3 + TILs in breast cancer is associated with tumor progression higher expression of FOXP3 + TILs indicates wores OS and DFS FOXP3 + TILs maybe a prognostic marker for breast cancer.
2024 Vol. 11 (3): 414-420 [Abstract] ( 56 ) HTML PDF (3336 KB)  ( 41 )
421 Advances in metabolomics - based studies of differential metabolites in cancer cachexia
1,2Xu Jing,1,2Chen Meiyu,1,2Zhang Dameng,1,2Du Peilong,1Zhu Xinting,1Han Leng,1Guo Cheng,1,2Yang Quanjun
Cancer cachexia is a complex multifactorial systemic syndrome that characterized by metabolic disorders mediating muscle atrophy and weight loss. Cancer cachexia is not only a contraindication to the comprehensive cancer treatment such as chemotherapy but also a deteriorating state with decreasing quality of life and short survival. Cancer cachexia occurs in 50%-80% of cancer patients with an incidence of over 85% in patients with pancreatic lung and gastric cancer. In addition 20% of cancer patients die as a result of the enormous wasting associated with cachexia. Metabolomics technology reveals the metabolic pathogenesis of diseases through the study of changes in the composition and concentration of metabolites and has been widely used in recent years for the characterisation and biomarker studies of tumours and metabolic diseases to elucidate the metabolic interactions of multiple tissues. In the present study we summarised the metabolic changes and pathways of cancer cachexia to elucidate the fundamental metabolic reprogramming of cancer cachexia. We reviewed the current status of biomarker research and the mechanism of cancer cachexia resulting from different types of cancer. By comparing the metabolic profiles of cancer cachexia from clinical samples and animal models we analysed the metabolic interactions of different cancer cachexias. The present study not only provides new ideas for the diagnosis and prevention of cancer cachexia but also new strategies for drug target research and clinical intervention research.
2024 Vol. 11 (3): 421-428 [Abstract] ( 63 ) HTML PDF (969 KB)  ( 56 )
429 Research progress on the correlation between dietary inflammation index and breast cancer
1Zhang Xuan,2Song Qiuxiang,2Zhao Xiaoyan,3Huang He,1Li Shupei,1Zuo Yingxiang,4Han Shifan
Long-term chronic inflammatory state can lead to imbalance of body function and even induce cancer. The occurrence and development of breast cancer are closely related to inflammation. As a controllable factor of the body 's inflammation level diet affects the health status of the body because of the different inflammatory properties and effects of different dietary components and nutrients. Dietary inflammatory index DII is an evaluation tool for the level of dietary inflammation in the general population by analyzing the association between various dietary components food nutrients and other bio-active food components and inflammatory biomarkers through a large amount of literature quantifying the overall inflammatory potential of the body 's diet and placing the individual diet in a continuous range from maximum anti-inflammatory to maximum pro-inflammatory. In recent years scholars at home and abroad have confirmed that DII has a strong correlation with the risk of breast cancer after continuous exploration and verification. However there is no consistent conclusion on the relationship between DII and the prognosis of breast cancer which needs further study. Healthy diet can prevent and improve chronic inflammation by regulating the production of inflammatory factors improve the body's immunity and create a favorable microenvironment for disease recovery. Therefore it is necessary to construct an anti - inflammatory diet intervention program to prevent the occurrence of breast cancer and its disease outcome so as to provide scientific theoretical basis for medical staff to formulate professional diet nursing. This article reviews the establishment development and evolution of DII and its related research with inflammation and breast cancer.
2024 Vol. 11 (3): 429-435 [Abstract] ( 75 ) HTML PDF (1003 KB)  ( 36 )
436 Research progress of out-of-hospital nutritional treatment compliance in patients with gastric cancer after surgery
He Ziwen, Xue Shan, Li Yue, Wang Yurou, Li Laiyou
Gastric cancer ranks fifth in global incidence and fourth in mortality with high incidence and poor prognosis. The incidence of malnutrition in patients with gastric cancer is high and it exists for a long time after surgery and the recovery cycle is long. Nutritional treatment is still needed after discharge. Good treatment compliance is the key to nutritional therapy but the current status of out-of-hospital nutritional therapy compliance of patients with gastric cancer after surgery is not optimistic and the effect of nutritional therapy is not good. At the same time there is a lack of standard evaluation tools for the assessment of nutritional treatment compliance of patients discharged after surgery resulting in a relatively low level of relevant studies which are often only studied as secondary indicators. However it can be confirmed that the patient ' s age knowledge level dietary preference postoperative complications socioeconomic factors health education and follow-up guidance of medical staff will affect the compliance of patients with out-of-hospital nutrition therapy. Therefore this paper summarized the current status and evaluation tools of out-of-hospital nutritional treatment compliance of postoperative patients with gastric cancer analyzed the influencing factors of post - discharge patients' nutritional treatment compliance from multiple perspectives and discussed the methods to improve patients' out-of-hospital nutritional treatment compliance. In order to provide reference for patients to develop personalized nutritional treatment plan enhance the viscosity of out-of-hospital nutritional treatment and improve the nutritional status of patie nts from the perspective of hospital.
2024 Vol. 11 (3): 436-442 [Abstract] ( 61 ) HTML PDF (2911 KB)  ( 62 )
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