BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outc...BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outcomes.However,postoperative deterioration in nutritional status and quality of life(QoL)remains a concern.The geriatric nutritional risk index(GNRI),which is calculated based on serum albumin levels and the ratio of normal body weight to ideal body weight,is easily accessible and accurate,making it increasingly popular in clinical practice.AIM To investigate the impact of GNRI-guided tiered nutritional interventions on postoperative nutritional recovery and QoL in elderly CRC patients.METHODS A retrospective analysis was conducted on 135 elderly CRC patients undergoing radical resection at our hospital from September 2022 to December 2024.Participants were divided into two cohorts:The research group(n=61)received GNRI-based graded nutritional support,while the control group(n=65)received conventional nutritional intervention.Clinical indicators,such as postoperative passage of gas by anus,incidence/duration of postoperative fever,hospitalization length and costs,were compared between the two groups.Nutritional biomarkers,including hemoglobin,prealbumin,transferrin,and Patient-Generated Subjective Global Assessment scores were assessed on postoperative day 1 and post-intervention(day 1 after intervention).The Generic QoL Inventory-74 was employed to assess physical function,social function,material life,and psychological function in the two groups.Immunoglobulin(Ig)(IgG,IgA,IgM)and inflammatory markers[nuclear factor kappa B,interleukin(IL)-1,tumor necrosis factor-α,IL-8]were compared between groups.Complication rates were also monitored.RESULTS The research group showed significantly faster postoperative passage of gas by anus,fewer instances of fever,reduced fever duration,shorter hospitalization duration,and lower costs compared with the control group(P<0.05).Following intervention,the research group exhibited higher levels of hemoglobin,prealbumin,and transferrin,and lower Patient-Generated Subjective Global Assessment scores vs the control group(P<0.05).Scores for physical function,social function,material life,and psychological function showed substantial improvement(P<0.05).Levels of IgG,IgA,and IgM were significantly elevated in the research group(P<0.05),while nuclear factor kappa B,IL-1,tumor necrosis factor-α,and IL-8 levels were noticeably lowered vs the control group(P<0.05).The incidence of overall complications within the research group reached 24.59%,notably lower than that(43.08%)observed in the control group(P<0.05).CONCLUSION GNRI-based graded nutritional intervention in elderly CRC patients can significantly improve postoperative recovery,enhance their nutritional status and QoL,promote immune function recovery,attenuate inflammation,and lower the incidence of postoperative complications.This protocol represents a clinically viable strategy for optimizing postoperative care.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and ...BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.展开更多
Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 wer...Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.展开更多
BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutri...BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.展开更多
Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study i...Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study investigates the nutritional quality of A.japonicus from different geographical regions and identifies genetic markers associated with these traits through a genome-wide association study(GWAS).We observed significant regional variations in the nutritional content of A.japonicus.Samples collected from Nanhuangcheng Island displayed the highest levels of saponins,whereas those from Laizhou exhibited the highest concentrations of glycosaminoglycans.Lingshan Island samples were the richest in amino acids,while samples from Rizhao contained the highest levels of polyunsaturated fatty acids.Through GWAS,265 candidate genes and related single nucleotide polymorphisms(SNPs)were identified as being significantly associated with essential nutritional traits,including genes like ubiquitin domain-containing protein 1(UBTD1),inactive pancreatic lipase-related protein 1,protein arginine N-methyltransferase 5(PRMT5)and GDP-fucose protein O-fucosyltransferase 1(POFUT1).This study advanced our knowledge of the genetic mechanisms underlying the nutritional quality of A.japonicus.The genetic markers identified herein o ffer crucial insights for breeding initiatives aimed at optimizing the nutritional profile of sea cucumbers.展开更多
Esophageal cancer is one of the common malignant tumors worldwide,and nutritional support during its treatment is of great significance for improving patients’quality of life and treatment outcomes.This paper aims to...Esophageal cancer is one of the common malignant tumors worldwide,and nutritional support during its treatment is of great significance for improving patients’quality of life and treatment outcomes.This paper aims to explore the application effect of full-course nutritional management in patients with esophageal cancer undergoing radiotherapy.Using a randomized controlled trial design,patients were randomly divided into an experimental group and a control group in a 1:1 ratio.The experimental group received full-course nutritional management,while the control group received routine care.Statistical analysis showed that the degree of weight loss in the experimental group after radiotherapy was significantly lower than that in the control group(P<0.05),the improvement in nutritional status was more obvious,and the incidence of radiotherapy-related adverse reactions was also significantly lower than that in the control group(P<0.05).It can be seen that full-course nutritional management can effectively improve the nutritional status of patients with esophageal cancer undergoing radiotherapy,reduce radiotherapy adverse reactions,and enhance patients’quality of life and treatment effects[1].It has important clinical application value and is worthy of promotion in clinical practice.展开更多
Objective： Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation （HSCT）. This study aimed to investigate the best nutritional assessment method for leukemia...Objective： Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation （HSCT）. This study aimed to investigate the best nutritional assessment method for leukemia patients after HSCT, and find the possible nutritional risk of the patients during the transplantation process in order to intervene in the patients with nutritional risks and undernourished patients timely, so that the entire transplantation process could be successfully completed. Methods： A prospective study was performed in 108 leukemia patients after HSCT, and different nutritional assessment methods, including nutritional risk screening 2002 （NRS2002）, mini nutritional assessment （MNA）, subjective globe assessment （SGA） and malnutritional universal screening tools （MUST）, were used. The associations between nutritional status of these patients and nutritional assessment methods were analyzed. Results： A total of 108 patients completed SGA, and 99 patients completed NRS2002, MNA and MUST. During the treatment process, 85.2% of the patients lost weight, wherein, 50% lost weight greater than 5%, and 42.6% had significantly reduced food intake. For nutritional risk assessment, the positive rates of NRS2002, MNA and MUST were 100%, 74.7% and 63.6%, respectively. There was a significant difference （P〈0.05） among the positive rates of NRS2002, MNA and MUST. In undernutrition assessment, the positive rate of SGA （83.3%） was significantly higher than that of MNA （17.2%） （P〈0.05）, and the incidence rate of nutritional risk among leukemia patients _〈30 years old was greater than that of patients 〉30 years old （P〈0.05）. Conclusions： Patients with leukemia were in poor nutritional status during and after HSCT. The leukemia patients 〈30 years old had a greater incidence rate of nutritional risk. As nutritional risk screening tool, the specificity of NRS2002 is not high, but it can be used for evaluating nutritional deficiencies. MNA is a good nutritional risk screening tool, but not an adequate tool for nutritional assessment. If assessment of undernutrition is necessary, the combination of all these screening tools and clinical laboratory indicators should he applied to improve accuracy.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outco...Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary.Lu et al recently published a retrospective,single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients:The albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),nutritional risk index,and the geriatric nutritional risk index.A significant correlation was found between the PNI,SII,NLR,and PLR and a hospital discharge of less than 15 days.In a univariable analysis,PNI,SII,NLR and PLR were significantly related to recurrence-free survival and,in a multivariable analysis PNI was associated with overall survival.Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness.Besides,the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones.These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.展开更多
This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers t...This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.展开更多
Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medic...Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.From 1999 to 2002,Dr.Shi was a postdoc fellow in School of Medicine,Johns Hopkins University,under the supervision of Adrian Barbul,M.D.,FACS,and then in New Jersey Medical School,Rutgers University,under the supervision of Edwin A.Deitch,M.D.,FACS.Dr.Han-Ping Shi was the Chairman of the Chinese Society for Parenteral&Enteral Nutrition(CSPEN)between 2018-2021.He is the founder Chairman of the Chinese Society of Nutritional Oncology(2012-2024),and the director of the Department of Academic,China Anti-Cancer Association(CACA)since 2017.Dr.Han-Ping Shi is currently the founder Editor-in-Chief of Electronic Journal of Metabolism and Nutrition of Cancer(Chinese),founder Editor-in-Chief of Journal of Nutritional Oncology(English)and founder Editor-in-Chief of Precision Nutrition(English).展开更多
Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,Ch...Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,China.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.展开更多
BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk ass...BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the per...Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.展开更多
This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatme...This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatments for gastric and esophageal cancers,respectively,but are frequently accompanied by significant postoperative malnutrition,which adversely impacts surgical and oncological outcomes as well as patients’quality of life.To address this,the European Society for Clinical Nutrition and Surgery and the National Comprehensive Cancer Network recommend early enteral feeding through FJT placement following major surgery.While previous studies have demonstrated that FJT is an effective and reliable route for nutritional support,its placement is invasive and carries associated risks.Consequently,many clinicians opt for less invasive alternatives such as total parenteral nutrition or nasogastric tube feeding,although these approaches yield variable results.This review explores the benefits and potential complications of FJT placement,identifies variability in clinical adoption and the absence of standardized protocols,and highlights areas for future research to optimize patient care in this challenging context.展开更多
Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate th...Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.展开更多
BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of im...BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.展开更多
The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via...The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.展开更多
文摘BACKGROUND Colorectal cancer(CRC)is a globally prevalent gastrointestinal malignant cancer,especially in elderly patients.Currently,surgery resection remains the primary treatment due to its favorable therapeutic outcomes.However,postoperative deterioration in nutritional status and quality of life(QoL)remains a concern.The geriatric nutritional risk index(GNRI),which is calculated based on serum albumin levels and the ratio of normal body weight to ideal body weight,is easily accessible and accurate,making it increasingly popular in clinical practice.AIM To investigate the impact of GNRI-guided tiered nutritional interventions on postoperative nutritional recovery and QoL in elderly CRC patients.METHODS A retrospective analysis was conducted on 135 elderly CRC patients undergoing radical resection at our hospital from September 2022 to December 2024.Participants were divided into two cohorts:The research group(n=61)received GNRI-based graded nutritional support,while the control group(n=65)received conventional nutritional intervention.Clinical indicators,such as postoperative passage of gas by anus,incidence/duration of postoperative fever,hospitalization length and costs,were compared between the two groups.Nutritional biomarkers,including hemoglobin,prealbumin,transferrin,and Patient-Generated Subjective Global Assessment scores were assessed on postoperative day 1 and post-intervention(day 1 after intervention).The Generic QoL Inventory-74 was employed to assess physical function,social function,material life,and psychological function in the two groups.Immunoglobulin(Ig)(IgG,IgA,IgM)and inflammatory markers[nuclear factor kappa B,interleukin(IL)-1,tumor necrosis factor-α,IL-8]were compared between groups.Complication rates were also monitored.RESULTS The research group showed significantly faster postoperative passage of gas by anus,fewer instances of fever,reduced fever duration,shorter hospitalization duration,and lower costs compared with the control group(P<0.05).Following intervention,the research group exhibited higher levels of hemoglobin,prealbumin,and transferrin,and lower Patient-Generated Subjective Global Assessment scores vs the control group(P<0.05).Scores for physical function,social function,material life,and psychological function showed substantial improvement(P<0.05).Levels of IgG,IgA,and IgM were significantly elevated in the research group(P<0.05),while nuclear factor kappa B,IL-1,tumor necrosis factor-α,and IL-8 levels were noticeably lowered vs the control group(P<0.05).The incidence of overall complications within the research group reached 24.59%,notably lower than that(43.08%)observed in the control group(P<0.05).CONCLUSION GNRI-based graded nutritional intervention in elderly CRC patients can significantly improve postoperative recovery,enhance their nutritional status and QoL,promote immune function recovery,attenuate inflammation,and lower the incidence of postoperative complications.This protocol represents a clinically viable strategy for optimizing postoperative care.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.
文摘Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.
基金Supported by the Special Project on Intravenous Therapy of Shanghai Nursing Society,No.2023JL-B08Naval Medical University Nursing“Zhuyuan”Talent Program.
文摘BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.
基金Supported by the Key Research and Development Program of Shandong(Nos.2021LZGC029,2023LZGC019)the National Natural Science Foundation of China(No.42076093)+1 种基金the Special Funds for the Central Government to Guide Local Science and Technology Development(No.YDZX2023043)the Taishan Scholars Program(No.tsqn202306279)。
文摘Sea cucumber Apostichopus japonicus is a crucial aquatic species known for its nutritional value.However,the genetic basis and regulatory mechanisms underlying its nutritional quality remain underexplored.This study investigates the nutritional quality of A.japonicus from different geographical regions and identifies genetic markers associated with these traits through a genome-wide association study(GWAS).We observed significant regional variations in the nutritional content of A.japonicus.Samples collected from Nanhuangcheng Island displayed the highest levels of saponins,whereas those from Laizhou exhibited the highest concentrations of glycosaminoglycans.Lingshan Island samples were the richest in amino acids,while samples from Rizhao contained the highest levels of polyunsaturated fatty acids.Through GWAS,265 candidate genes and related single nucleotide polymorphisms(SNPs)were identified as being significantly associated with essential nutritional traits,including genes like ubiquitin domain-containing protein 1(UBTD1),inactive pancreatic lipase-related protein 1,protein arginine N-methyltransferase 5(PRMT5)and GDP-fucose protein O-fucosyltransferase 1(POFUT1).This study advanced our knowledge of the genetic mechanisms underlying the nutritional quality of A.japonicus.The genetic markers identified herein o ffer crucial insights for breeding initiatives aimed at optimizing the nutritional profile of sea cucumbers.
文摘Esophageal cancer is one of the common malignant tumors worldwide,and nutritional support during its treatment is of great significance for improving patients’quality of life and treatment outcomes.This paper aims to explore the application effect of full-course nutritional management in patients with esophageal cancer undergoing radiotherapy.Using a randomized controlled trial design,patients were randomly divided into an experimental group and a control group in a 1:1 ratio.The experimental group received full-course nutritional management,while the control group received routine care.Statistical analysis showed that the degree of weight loss in the experimental group after radiotherapy was significantly lower than that in the control group(P<0.05),the improvement in nutritional status was more obvious,and the incidence of radiotherapy-related adverse reactions was also significantly lower than that in the control group(P<0.05).It can be seen that full-course nutritional management can effectively improve the nutritional status of patients with esophageal cancer undergoing radiotherapy,reduce radiotherapy adverse reactions,and enhance patients’quality of life and treatment effects[1].It has important clinical application value and is worthy of promotion in clinical practice.
文摘Objective： Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation （HSCT）. This study aimed to investigate the best nutritional assessment method for leukemia patients after HSCT, and find the possible nutritional risk of the patients during the transplantation process in order to intervene in the patients with nutritional risks and undernourished patients timely, so that the entire transplantation process could be successfully completed. Methods： A prospective study was performed in 108 leukemia patients after HSCT, and different nutritional assessment methods, including nutritional risk screening 2002 （NRS2002）, mini nutritional assessment （MNA）, subjective globe assessment （SGA） and malnutritional universal screening tools （MUST）, were used. The associations between nutritional status of these patients and nutritional assessment methods were analyzed. Results： A total of 108 patients completed SGA, and 99 patients completed NRS2002, MNA and MUST. During the treatment process, 85.2% of the patients lost weight, wherein, 50% lost weight greater than 5%, and 42.6% had significantly reduced food intake. For nutritional risk assessment, the positive rates of NRS2002, MNA and MUST were 100%, 74.7% and 63.6%, respectively. There was a significant difference （P〈0.05） among the positive rates of NRS2002, MNA and MUST. In undernutrition assessment, the positive rate of SGA （83.3%） was significantly higher than that of MNA （17.2%） （P〈0.05）, and the incidence rate of nutritional risk among leukemia patients _〈30 years old was greater than that of patients 〉30 years old （P〈0.05）. Conclusions： Patients with leukemia were in poor nutritional status during and after HSCT. The leukemia patients 〈30 years old had a greater incidence rate of nutritional risk. As nutritional risk screening tool, the specificity of NRS2002 is not high, but it can be used for evaluating nutritional deficiencies. MNA is a good nutritional risk screening tool, but not an adequate tool for nutritional assessment. If assessment of undernutrition is necessary, the combination of all these screening tools and clinical laboratory indicators should he applied to improve accuracy.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
文摘Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary.Lu et al recently published a retrospective,single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients:The albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),nutritional risk index,and the geriatric nutritional risk index.A significant correlation was found between the PNI,SII,NLR,and PLR and a hospital discharge of less than 15 days.In a univariable analysis,PNI,SII,NLR and PLR were significantly related to recurrence-free survival and,in a multivariable analysis PNI was associated with overall survival.Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness.Besides,the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones.These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.
文摘This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.
文摘Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Director of the Faculty of Clinical Nutrition,Capital Medical University.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.From 1999 to 2002,Dr.Shi was a postdoc fellow in School of Medicine,Johns Hopkins University,under the supervision of Adrian Barbul,M.D.,FACS,and then in New Jersey Medical School,Rutgers University,under the supervision of Edwin A.Deitch,M.D.,FACS.Dr.Han-Ping Shi was the Chairman of the Chinese Society for Parenteral&Enteral Nutrition(CSPEN)between 2018-2021.He is the founder Chairman of the Chinese Society of Nutritional Oncology(2012-2024),and the director of the Department of Academic,China Anti-Cancer Association(CACA)since 2017.Dr.Han-Ping Shi is currently the founder Editor-in-Chief of Electronic Journal of Metabolism and Nutrition of Cancer(Chinese),founder Editor-in-Chief of Journal of Nutritional Oncology(English)and founder Editor-in-Chief of Precision Nutrition(English).
文摘Han-Ping Shi,M.D.,Ph.D.,FACS,Professor of Surgery,Oncology and Nutrition.He is the current Chairman of the Department of GI Surgery/Clinical Nutrition at Beijing Shijitan Hospital,Capital Medical University,Beijing,China.Dr.Shi received his M.D.degree at the School of Medicine,Wuhan University,Wuhan,and his Ph.D.degree at the Second Military Medical University,Shanghai,China.
文摘BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
基金funded by the Jiangsu Graduate Student Practice and Innovation Program(No.SJCX23_0665).
文摘Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.
文摘This minireview synthesizes literature on the use of feeding jejunostomy tubes(FJTs)in the postoperative management of gastroesophageal cancer patients.Gastrectomy and esophagectomy remain the primary curative treatments for gastric and esophageal cancers,respectively,but are frequently accompanied by significant postoperative malnutrition,which adversely impacts surgical and oncological outcomes as well as patients’quality of life.To address this,the European Society for Clinical Nutrition and Surgery and the National Comprehensive Cancer Network recommend early enteral feeding through FJT placement following major surgery.While previous studies have demonstrated that FJT is an effective and reliable route for nutritional support,its placement is invasive and carries associated risks.Consequently,many clinicians opt for less invasive alternatives such as total parenteral nutrition or nasogastric tube feeding,although these approaches yield variable results.This review explores the benefits and potential complications of FJT placement,identifies variability in clinical adoption and the absence of standardized protocols,and highlights areas for future research to optimize patient care in this challenging context.
基金supported by grants from the Joint Tackling Project of Pudong Health Committee of Shanghai(PW2022D08)Medical Discipline Construction Project of Pudong Health Committee of Shanghai(PWZxq2022-6)+1 种基金Health and Family Planning Research Project of Pudong Health Committee of Shanghai(PW2021A-38)Youth Scientific Research Cultivation Fund Project of Shanghai Oriental Hospital(DFPY2022020).
文摘Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.
文摘BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.
文摘The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.
