Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales...Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales(simplified Chinese Version).The software program SPSS 25.0 was used for statistical analysis of the survey data.Results The average scores of depression,anxiety,and stress of inpatients with cancer were 12.17,11.84,and 13.98 respectively,which were higher than the normal range.The scores of anxiety and stress of inpatients with different caregivers were statistically different(P=0.024/0.036).The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers.There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs(P=0.026),and those with religious beliefs had greater incidence of stress.The score of anxiety was significantly higher for inpatients with children than for inpatients without children(P=0.040).Conclusion The anxiety,depression,and stress levels of inpatients with cancer are relatively high.It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.展开更多
Many studies pointed out that psychological pain is not limited to the cancer patients themselves,but their caregivers also experience different levels of psychological problems such as depression,anxiety,and stress.T...Many studies pointed out that psychological pain is not limited to the cancer patients themselves,but their caregivers also experience different levels of psychological problems such as depression,anxiety,and stress.This article attempts to review the mental health status,assessment tools,and psychological interventions of the caregivers of cancer patients,and calls on social and medical workers to pay attention to the mental and physical health status of the caregivers of cancer patients.展开更多
Fat overload syndrome is a rare complication of intravenous fat emulsion therapy. It is due to infusion rate and/or dose of triglycerides lipid emulsion surpassing fat clearance capacity of the body. Several reports i...Fat overload syndrome is a rare complication of intravenous fat emulsion therapy. It is due to infusion rate and/or dose of triglycerides lipid emulsion surpassing fat clearance capacity of the body. Several reports in the literature described fat overload syndrome which was caused by rapid infusion of lipid emulsions, all with soybean-based lipid emulsions. We describe one patient who received parenteral nutrition with 20% medium-chain and long-chain triglycerides lipid perioperatively for volvulus of sigmoid colon, followed by a precipitous drop in blood platelet suggestive of fat overload syndrome. After a complete withdrawal of medium-chain and long-chain triglycerides lipid emulsion, the platelet levels gradually returned to be normal.展开更多
Primitive neuroectodermal tumor (PNET) and Ewing’s sarcoma (EWS) are small round cell tumors occurring mainly in children and adolescents, rarely in adults. It can occur in multiple tissues and organs including kidne...Primitive neuroectodermal tumor (PNET) and Ewing’s sarcoma (EWS) are small round cell tumors occurring mainly in children and adolescents, rarely in adults. It can occur in multiple tissues and organs including kidney, adrenal, bladder, liver, small intestine, colon and rectum, with a preferred location within the chest area, in the limbs and around the spine, but with rare cases of abdominal, pelvic or retroperitoneal. Here we present a case of the retroperitoneal PENT/EWS in a 38-year-old man and we discuss the clinical features, histopathological characteristics, diagnosis, treatment and prognosis.展开更多
Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with mali...Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.展开更多
Mental distress is prevalent among cancer patients.Many measurements have been developed to screen and evaluate such distress.About one-third of the persons with cancer will experience significant levels of distress,r...Mental distress is prevalent among cancer patients.Many measurements have been developed to screen and evaluate such distress.About one-third of the persons with cancer will experience significant levels of distress,requiring targeted psychosocial intervention.Mental distress has been endorsed as the sixth vital sign by the International Psycho-Oncology Society(IPOS) in 2009.The need for effective screening and psychological interventions is well recognized as a necessary,integral part of oncology care.This systematic review examines the psychometric properties of the existing tools used to screen patients for emotional distress and the applicable intervention methods.展开更多
Background and Objectives:Patients with gastrointestinal(GI)malignancies are at high risk for malnutrition because of reduced food intake,poor digestion,and altered absorption.Methods and Study Design:In a retrospecti...Background and Objectives:Patients with gastrointestinal(GI)malignancies are at high risk for malnutrition because of reduced food intake,poor digestion,and altered absorption.Methods and Study Design:In a retrospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery(gastric,colon,or anorectal cancers),we found that malnutrition was common yet often overlooked.Our review identified records for 349 adult GI-tumor surgery patients.The Nutrition Risk Screening-2002(NRS-2002)was the most frequently used screening instrument.In further review,we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements(ONS)to outcomes for patients who were not given ONS.Results:Review of results revealed that only 20%of patients in our sample underwent nutritional screening or assessment on admission.Of those who did,nearly 60%were malnourished.Although due to small sample sizes,no statistically significant differences were observed,malnourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day.Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications,slowed recovery,longer hospital stays,and readmissions.Conclusions:Based on our findings,nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.展开更多
Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinic...Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods:This retrospective study included 165 patients with AD from the Chinese Imaging,Biomarkers,and Lifestyle(CIBL)cohort between June 1,2021,and March 31,2022.Data on demographics,neuropsychological assessments,single-nucleotide polymorphisms of AD risk genes,and regional brain volumes were collected.A multivariate logistic regression model identified BPSD-associated factors,for subsequently constructing a diagnostic nomogram.This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1,2022,and February 1,2023.Area under receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were used to assess the discrimination,calibration,and clinical applicability of the nomogram.Results:Factors independently associated with BPSD were:CETP rs1800775(odds ratio[OR]=4.137,95%confidence interval[CI]:1.276-13.415,P=0.018),decreased Mini Nutritional Assessment score(OR=0.187,95%CI:0.086-0.405,P<0.001),increased caregiver burden inventory score(OR=8.993,95%CI:3.830-21.119,P<0.001),and decreased brain stem volume(OR=0.006,95%CI:0.001-0.191,P=0.004).These variables were incorporated into the nomogram.The area under the ROC curve was 0.925(95%CI:0.884-0.967,P<0.001)in the internal validation and 0.791(95%CI:0.686-0.895,P<0.001)in the external validation.The calibration plots showed favorable consistency between the prediction of nomogram and actual observations,and the DCA showed that the model was clinically useful in both validations.Conclusion:A novel nomogram was established and validated based on lipid metabolism-related genes,nutritional status,and brain stem volumes,which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration:Chictr.org.cn,ChiCTR2100049131.展开更多
Alzheimer's disease(AD)is the leading cause of dementia in older individuals and is an escalating challenge to global public health.Pharmacy therapy of AD is one of the well-funded areas;however,little progress ha...Alzheimer's disease(AD)is the leading cause of dementia in older individuals and is an escalating challenge to global public health.Pharmacy therapy of AD is one of the well-funded areas;however,little progress has been made due to the complex pathogenesis.Recent evidence has demonstrated that modifying risk factors and lifestyle may prevent or delay the incidence of AD by 40%,which suggests that the management should pivot from single pharmacotherapy toward a multipronged approach because AD is a complex and multifaceted disease.Recently,the gut-microbiota-brain axis has gained tremendous traction in the pathogenesis of AD through bidirectional communication with multiple neural,immune,and metabolic pathways,providing new insights into novel therapeutic strategies.Dietary nutrition is an important and profound environmental factor that influences the composition and function of the microbiota.The Nutrition for Dementia Prevention Working Group recently found that dietary nutrition can affect cognition in AD-related dementia directly or indirectly through complex interactions of behavioral,genetic,systemic,and brain factors.Thus,considering the multiple etiologies of AD,nutrition represents a multidimensional factor that has a profound effect on AD onset and development.However,mechanistically,the effect of nutrition on AD is uncertain;therefore,optimal strategies or the timing of nutritional intervention to prevent or treat AD has not been established.Thus,this review summarizes the current state of knowledge concerning nutritional disorders,AD patient and caregiver burden,and the roles of nutrition in the pathophysiology of AD.We aim to emphasize knowledge gaps to provide direction for future research and to establish optimal nutrition-based intervention strategies for AD.展开更多
Malnutrition reduces tolerance and effectiveness of anti-tumor treatment(ANT),increases the risk of complications,medical costs,and death(Arends et al.,2017).About 40%of patients with cancer die because of malnutritio...Malnutrition reduces tolerance and effectiveness of anti-tumor treatment(ANT),increases the risk of complications,medical costs,and death(Arends et al.,2017).About 40%of patients with cancer die because of malnutrition rather than the disease itself(Barton,2017;Roeland et al.,2020).In order to set up a panorama for association among nutrition status,nutrition support treatment(NST),ANT and outcomes in patients with neoplasms,the Chinese Society of Nutritional Oncology(CSNO)conducted a multicenter prospective cohort program called Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)from 2013.展开更多
Dear Editor,Malnutrition is a prevalent disease in oncology practice(Arends et al.,2017).With its cancer-specific prevalence ranging from 21%–72%,malnutrition is responsible for 10%–20% cancer deaths(Yin et al.,2021...Dear Editor,Malnutrition is a prevalent disease in oncology practice(Arends et al.,2017).With its cancer-specific prevalence ranging from 21%–72%,malnutrition is responsible for 10%–20% cancer deaths(Yin et al.,2021b).However,malnutrition is often underestimated,misclassified,or left untreated in cancer care(Hébuterne et al.,2014).展开更多
Whereas biochemical markers are available for most types of cell death, current studies on non-autonomous cell death by entosis rely strictly on the identification of cell-in-cell structures (CICs), a unique morpholog...Whereas biochemical markers are available for most types of cell death, current studies on non-autonomous cell death by entosis rely strictly on the identification of cell-in-cell structures (CICs), a unique morphological readout that can only be quantified manually at present. Moreover, the manual CIC quantification is generally over-simplified as CIC counts, which represents a major hurdle against profound mechanistic investigations. In this study, we take advantage of artificial intelligence technology to develop an automatic identification method for CICs (AIM-CICs), which performs comprehensive CIC analysis in an automated and efficient way. The AIM-CICs, developed on the algorithm of convolutional neural network, can not only differentiate between CICs and non-CICs (the area under the receiver operating characteristic curve (AUC) > 0.99), but also accurately categorize CICs into five subclasses based on CIC stages and cell number involved (AUC > 0.97 for all subclasses). The application of AIM-CICs would systemically fuel research on CIC-mediated cell death, such as high-throughput screening.展开更多
基金a grant from the National Key Research and Development Program:the Key Technology of Palliative Care and Nursing for Cancer Patients(No.2017YFC1309200).
文摘Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales(simplified Chinese Version).The software program SPSS 25.0 was used for statistical analysis of the survey data.Results The average scores of depression,anxiety,and stress of inpatients with cancer were 12.17,11.84,and 13.98 respectively,which were higher than the normal range.The scores of anxiety and stress of inpatients with different caregivers were statistically different(P=0.024/0.036).The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers.There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs(P=0.026),and those with religious beliefs had greater incidence of stress.The score of anxiety was significantly higher for inpatients with children than for inpatients without children(P=0.040).Conclusion The anxiety,depression,and stress levels of inpatients with cancer are relatively high.It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.
基金Supported by a grant from The National Key Research and Development Program:The Key Technology of Palliative Care and Nursing for Cancer Patients(No.2017YFC1309200).
文摘Many studies pointed out that psychological pain is not limited to the cancer patients themselves,but their caregivers also experience different levels of psychological problems such as depression,anxiety,and stress.This article attempts to review the mental health status,assessment tools,and psychological interventions of the caregivers of cancer patients,and calls on social and medical workers to pay attention to the mental and physical health status of the caregivers of cancer patients.
文摘Fat overload syndrome is a rare complication of intravenous fat emulsion therapy. It is due to infusion rate and/or dose of triglycerides lipid emulsion surpassing fat clearance capacity of the body. Several reports in the literature described fat overload syndrome which was caused by rapid infusion of lipid emulsions, all with soybean-based lipid emulsions. We describe one patient who received parenteral nutrition with 20% medium-chain and long-chain triglycerides lipid perioperatively for volvulus of sigmoid colon, followed by a precipitous drop in blood platelet suggestive of fat overload syndrome. After a complete withdrawal of medium-chain and long-chain triglycerides lipid emulsion, the platelet levels gradually returned to be normal.
文摘Primitive neuroectodermal tumor (PNET) and Ewing’s sarcoma (EWS) are small round cell tumors occurring mainly in children and adolescents, rarely in adults. It can occur in multiple tissues and organs including kidney, adrenal, bladder, liver, small intestine, colon and rectum, with a preferred location within the chest area, in the limbs and around the spine, but with rare cases of abdominal, pelvic or retroperitoneal. Here we present a case of the retroperitoneal PENT/EWS in a 38-year-old man and we discuss the clinical features, histopathological characteristics, diagnosis, treatment and prognosis.
基金supported by the National Key Research and Development Program(Grant No.2022YFC2009600)。
文摘Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.
基金Supported by a grant from The National Key Research and Development Program:The Key Technology of Palliative Care and Nursing for Cancer Patients(No.2017YFC1309200)
文摘Mental distress is prevalent among cancer patients.Many measurements have been developed to screen and evaluate such distress.About one-third of the persons with cancer will experience significant levels of distress,requiring targeted psychosocial intervention.Mental distress has been endorsed as the sixth vital sign by the International Psycho-Oncology Society(IPOS) in 2009.The need for effective screening and psychological interventions is well recognized as a necessary,integral part of oncology care.This systematic review examines the psychometric properties of the existing tools used to screen patients for emotional distress and the applicable intervention methods.
基金supported by Abbott Laboratories(Chicago,IL,US).
文摘Background and Objectives:Patients with gastrointestinal(GI)malignancies are at high risk for malnutrition because of reduced food intake,poor digestion,and altered absorption.Methods and Study Design:In a retrospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery(gastric,colon,or anorectal cancers),we found that malnutrition was common yet often overlooked.Our review identified records for 349 adult GI-tumor surgery patients.The Nutrition Risk Screening-2002(NRS-2002)was the most frequently used screening instrument.In further review,we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements(ONS)to outcomes for patients who were not given ONS.Results:Review of results revealed that only 20%of patients in our sample underwent nutritional screening or assessment on admission.Of those who did,nearly 60%were malnourished.Although due to small sample sizes,no statistically significant differences were observed,malnourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day.Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications,slowed recovery,longer hospital stays,and readmissions.Conclusions:Based on our findings,nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.
基金supported by grants from the National Key Research and Development Program of China(Nos.2021YFC2500100 and 2021YFC2500103)the National Natural Science Foundation of China(Nos.82071187 and 81870821)
文摘Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods:This retrospective study included 165 patients with AD from the Chinese Imaging,Biomarkers,and Lifestyle(CIBL)cohort between June 1,2021,and March 31,2022.Data on demographics,neuropsychological assessments,single-nucleotide polymorphisms of AD risk genes,and regional brain volumes were collected.A multivariate logistic regression model identified BPSD-associated factors,for subsequently constructing a diagnostic nomogram.This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1,2022,and February 1,2023.Area under receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were used to assess the discrimination,calibration,and clinical applicability of the nomogram.Results:Factors independently associated with BPSD were:CETP rs1800775(odds ratio[OR]=4.137,95%confidence interval[CI]:1.276-13.415,P=0.018),decreased Mini Nutritional Assessment score(OR=0.187,95%CI:0.086-0.405,P<0.001),increased caregiver burden inventory score(OR=8.993,95%CI:3.830-21.119,P<0.001),and decreased brain stem volume(OR=0.006,95%CI:0.001-0.191,P=0.004).These variables were incorporated into the nomogram.The area under the ROC curve was 0.925(95%CI:0.884-0.967,P<0.001)in the internal validation and 0.791(95%CI:0.686-0.895,P<0.001)in the external validation.The calibration plots showed favorable consistency between the prediction of nomogram and actual observations,and the DCA showed that the model was clinically useful in both validations.Conclusion:A novel nomogram was established and validated based on lipid metabolism-related genes,nutritional status,and brain stem volumes,which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration:Chictr.org.cn,ChiCTR2100049131.
基金the National Natural Science Foundation of China(82071187 and 81870821)the National Key Research and Development Program of China(2021YFC2500100 and 2021YFC2500103)the Beijing Youth Talent Team Support Program(2018000021223TD08)。
文摘Alzheimer's disease(AD)is the leading cause of dementia in older individuals and is an escalating challenge to global public health.Pharmacy therapy of AD is one of the well-funded areas;however,little progress has been made due to the complex pathogenesis.Recent evidence has demonstrated that modifying risk factors and lifestyle may prevent or delay the incidence of AD by 40%,which suggests that the management should pivot from single pharmacotherapy toward a multipronged approach because AD is a complex and multifaceted disease.Recently,the gut-microbiota-brain axis has gained tremendous traction in the pathogenesis of AD through bidirectional communication with multiple neural,immune,and metabolic pathways,providing new insights into novel therapeutic strategies.Dietary nutrition is an important and profound environmental factor that influences the composition and function of the microbiota.The Nutrition for Dementia Prevention Working Group recently found that dietary nutrition can affect cognition in AD-related dementia directly or indirectly through complex interactions of behavioral,genetic,systemic,and brain factors.Thus,considering the multiple etiologies of AD,nutrition represents a multidimensional factor that has a profound effect on AD onset and development.However,mechanistically,the effect of nutrition on AD is uncertain;therefore,optimal strategies or the timing of nutritional intervention to prevent or treat AD has not been established.Thus,this review summarizes the current state of knowledge concerning nutritional disorders,AD patient and caregiver burden,and the roles of nutrition in the pathophysiology of AD.We aim to emphasize knowledge gaps to provide direction for future research and to establish optimal nutrition-based intervention strategies for AD.
基金This work was supported by the National Key Research and Development Program of China(2017YFC1309200).
文摘Malnutrition reduces tolerance and effectiveness of anti-tumor treatment(ANT),increases the risk of complications,medical costs,and death(Arends et al.,2017).About 40%of patients with cancer die because of malnutrition rather than the disease itself(Barton,2017;Roeland et al.,2020).In order to set up a panorama for association among nutrition status,nutrition support treatment(NST),ANT and outcomes in patients with neoplasms,the Chinese Society of Nutritional Oncology(CSNO)conducted a multicenter prospective cohort program called Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)from 2013.
基金supported in part by the National Key Research and Development Program(2017YFC1309200)the National Natural Science Foundation of China(81673167)。
文摘Dear Editor,Malnutrition is a prevalent disease in oncology practice(Arends et al.,2017).With its cancer-specific prevalence ranging from 21%–72%,malnutrition is responsible for 10%–20% cancer deaths(Yin et al.,2021b).However,malnutrition is often underestimated,misclassified,or left untreated in cancer care(Hébuterne et al.,2014).
基金This workwas supported by Beijing Municipal Natural Science Foundation(KZ202110025029 to H.H.)the National Key R&D Program of China(2022YFC3600100 to Q.S.and H.H.)+2 种基金the National Natural Science Foundation of China(32100608 to C.W.,82002918 and 31970685 to Q.S.)Beijing Municipal Administration of Hospitals Incubating Program(PX2021033 to H.H.)Beijing Postdoctoral Research Foundation(2021-ZZ-027 to M.T.).
文摘Whereas biochemical markers are available for most types of cell death, current studies on non-autonomous cell death by entosis rely strictly on the identification of cell-in-cell structures (CICs), a unique morphological readout that can only be quantified manually at present. Moreover, the manual CIC quantification is generally over-simplified as CIC counts, which represents a major hurdle against profound mechanistic investigations. In this study, we take advantage of artificial intelligence technology to develop an automatic identification method for CICs (AIM-CICs), which performs comprehensive CIC analysis in an automated and efficient way. The AIM-CICs, developed on the algorithm of convolutional neural network, can not only differentiate between CICs and non-CICs (the area under the receiver operating characteristic curve (AUC) > 0.99), but also accurately categorize CICs into five subclasses based on CIC stages and cell number involved (AUC > 0.97 for all subclasses). The application of AIM-CICs would systemically fuel research on CIC-mediated cell death, such as high-throughput screening.
