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Background:Malnutrition is common in patients with cancer, whichadversely affectsthesurvival and quality of life ofcancer patients.However, there is no national data on the prevalence of malnutrition inChinese cancer patients. Thisstudy aims to evaluate the prevalenceof malnutrition and quality of life(QOL)ofChinese patients with localregional, recurrentor metastatic cancer,to address the prognostic value of nutritional status and QOLon the survival of cancer patients in China and to validate the patient-generated subjective global assessment (PG-SGA) questionnaire in Chinese cancer patients.Methods:Thisisanobservational,multi-centered,and hospital-based prospective cohort study.We aimed to recruit 50,000 cancer patients (age 18and above)overan 8-year period.Data collection will occur within 48hrafter patientsare admitted to hospital, 30-days after hospital admission, and the follow-up will be conducted1-8years after enrolment. The primary outcomeisoverall survival, and secondaryoutcomes arelength of hospital stay and hospital costs. Factors measured are demographic characteristics, tumor characteristics, anthropometry measurements,hematological measurement, body composition, PG-SGAscores,Karnofsky performance status scores,and QLQ C30 scores. This protocol wasapproved by local ethical committees of all the participant hospitals.Conclusions: This multi-centered, large-scale, long-time follow-up prospective study will help diagnose malnutrition in cancer patients in China, and identify the related risk factors associated with the negative outcomes. The anticipated results will highlight the need for a truly scientific appraisal of nutrition therapy, and help to improve outcomes among cancer patients in China.Trial Registration: The trial has been registered with the Chinese Clinical Trial Registry, ChiCTR1800020329. Registered on 19 December 2018
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Immunological checkpoint inhibitors of anti-programmed cell death-1 and programmed cell death ligand-1(PD-L1)have already demonstrated remarkable clinical efficacy for solid tumors,however,the effectiveness of single drug therapy in immunotherapy is not very high. Therefore,exploring the appropriate therapeutic predictive biomarkers so as to accurately identify the potential patients suitable for this therapy has become a research hotspot. Studies have shown that biomarkers such as PD-L1,tumor mutation burden and mismatch repair deficiency may be related to the efficacy of immunotherapy. In-depth analysis and exploration of these markers may provide a basis for determining those patients who are more likely to benefit from check-point inhibitor.
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BACKGROUND:The traditional treatment for thoracolumbar vertebral fractures is posterior short-segment pedicle screw fixation. This method uses vertebral soft tissue stretch through distraction reduction mechanism, makes shift bone reset, and restores shape and height of vertebral body. Long-term folow-up found that part of cases experience complications such as vertebral height loss, loss of spinal correction of Cobb angle, the pedicle screw breakage and loosening. OBJECTIVE:To explore clinical effects of pedicle screw fixation combined with the implantation of artificial bone composite for the treatment of thoracolumbar fractures, and to compare with conventional pedicle screw. METHODS: A total of 80 patients with thoracolumbar fractures, who were treated in the Yantaishan Hospital from March 2011 to May 2014, were randomly divided into two groups. In the experimental group, patients received pedicle screw fixation combined with the implantation of artificial bone composite. In the control group, patients received routine pedicle fixation. Pain visual analog scale score was evaluated before treatment and at 6 months after treatment in patients of both groups, and easement of pain was evaluated after treatment. Vertebral body height (normal anterior flange height and up and down the front cone height and the ratio of the average multiplied by 100%) and sagittal Cobb angle (sagittal measurements of X-ray film) were measured in patients of both groups before treatment and at 1 and 12 months after treatment. According to conventional hierarchical evaluation criteria used al over the world, prognosis was assessed at 6 months after treatment, including basic cure, powerfuly, effectively, and invalid. RESULTS AND CONCLUSION: At 6 months after treatment, significant differences in pain visual analog scale scores were detected in the experimental group (2.4 points) and control group (3.7 points) (P 0.05). The height of the injured vertebra and Cobb angle were better in the experimental group compared with the control group at 1 and 12 months after treatment (P < 0.05). Significant differences in treatment efficiency were detectable between the experimental group (90%) and the control group (73%) at 6 months after treatment (P < 0.05). These data indicate that pedicle screw fixation combined with the implantation of artificial bone composite in the treatment of thoracolumbar fractures can be used to fix fracture reduction, effectively restore height of injured vertebral body, prevent postoperative Cobb angle loss, and improve the treatment efficiency.
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Objective To discuss the surgical indications,relative merits and clinical outcomes of anterior reconstruction plate fixation for treating unstable posterior pelvic ring injuries.MethodsA retrospective study was done on clinical data of 36 patients with unstable posterior pelvic ring injuries treated with anterior reconstruction plate fixation from August 2004 to July 2010 and followed up for minimum one year.There were 25 males and 11 females,at mean age of 35.8 years ( range,13-62 years).There were two patients with anterior dislocation of the sacroiliac joint and 34 with posterior dislocation.According to Tile classification,there were four patients with type B fractures ( B1:3,B2:1 ) and 32 with type C fractures (C1-1:17,C1-2:12,C2:2,C3:1 ).Results All patients were followed up for average 2.3 years ( range,1-6 years).Fat liquefaction and superficial infection were founded in two patients who were cured by dressing change and frequent but low-dose blood transfusion.Eight patients were subjected to iatrogenic lateral femoral cutaneous nerve injury.Meanwhile,five of them was recovered after treatment with neurotrophic drugs,but there were still three patients leaving lateral thigh numbness.One patient had L5 nerve root injury due to pull force,and was recovered after three months of neurotrophic drug therapy.According to Matta and Tometta criteria,the reduction results were excellent in 23 patients,good in 11 and fair in four,with excellence rate of 94％.No reduction loss or implant failure occurred.According to Majeed scoring system,the clinical outcomes were excellent in 17 patients,good in 14,fair in four and poor in one,with excellence rate of 86％.Of the seven patients pre-operatively associated with sacral plexusinjury,three obtained full recovery,two got partial recovery and two were free from recovery.Conclusion The anterior reconstruction plate fixation takes advantages of wide surgical indications,simple exposure,low infection rate,satisfactory reduction and solid fixation and may be a main treatment method for unstable posterior pelvic ring injuries.
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Objective To evaluate the clinical significance of plasma ionized calcium (ICa) and total calcium (TCa) measurement in diagnosis of tumor-associated hypercalcemia. Methods The heparin lithium anticoagulated plasma were collected and measured with ion selective electrode (ISE) and orthocresolphthalein complexone (OCPC) method for ICa and TCa in 77 patients with malignant tumor (tumor group) and 44 healthy controls (control group). Meanwhile,plasma albumin and pH value were measured to correct TCa (cTCa) and ICa(nICa). The results were analyzed. Results The levels of cTCa,ICa and nICa in tumor group were significantly higher than those in control group(P＜ 0.01 ) ,but there was no significant difference of TCa between two groups (P ＞ 0.05 ). cTCa ＞ 2.70 mmol/L, nICa ＞ 1.35 mmol/L as the hypercalcemia eritical value, the positive rate of nICa and cTCa were 18.18% (14/77) and 6.49% (5/77)respectively,the difference was significant (P = 0.023). Conclusion Determination of ICa may be more clinical meaningful than TCa for tumor-associated hypercalcemia.
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Objective To observe the ultrastructure and absorption function of colon mucosa in rat with ultra-short bowel syndrome. Methods Totally 30 SD rats were randomly divided into three groups: ultra-short bowel group (90%-95% of the intestine was surgically resected, n = 10), sham group (n = 10), and normal control group (n = 10). All animals were given with enteral nutrition. Scanning electron microscopy was performed 21 days later to observe the morphology of mucosal surface, and transmission electron microscopy was performed to observe the ultrastructural changes of intestinal epithelial cells. The absorption of colon to water, carbohydrates, and amino acid determined after 3 hours of closed perfusion of the colon with D-xylose solution and 15N-glycine on the continuous cycle of colon. Results As shown by the transmission electron microscopy, compared with the normal control group, rats in the ultra-short bowel group showed significantly decreased goblet cells on colonic mucosl surface, increased epithelial cells, longer and denser microvillus, increased area of membrane surface, increased number of cell-cell junctions, increased number of desmosome, tight junction, and gap junctions, higher development of endoplasmic reticulum and dictyosome, and increased number of mitochondria. As shown in the screening electron microscopy, compared with the normal rats, rats in the ultra-short bowl group had significantly deeper colon folds, thicker mucous membrane, increased number of bay openings, and longer and denser microvillus-like structures inside bays. The capability of water absorption was signicatnly higher in the ultra-short bowl group than in the sham group and normal control group (P = 0. 000) . The absorption rates of xylose and 15 N-glycine were also significantly higher in the ultra-short bowl group than in the control group (P ＜ 0. 01). Conclusions The absorption capability can be compensatively increased in rats with ultra-short bowel syndrome. Decreased apoptosis of colon mucosa cells, increased absorption cells, hyperplasia of microvilli, increased area of the membrane surface,and increased number of mitochondria may constitute its material and energy bases.
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0.05).The complications of PICC included phlebitis,catheter occulusion,infection,malposition of catheter,but no pneumothorax or hemopneumothorax occured .Group PICC had higher phlebitis than that in group CVC(P
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0.05).Conclusion:The method of insulin directly added into TNA can efficiently manage the blood glucose level during parenteral nutrition support.
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Objective To evaluate the effect and mechanism of non-steroidal anti-flammatory drags(NSAIDs) on the colon cancer cell growth by using S-nitrosoglutathione(GSNO) which can produce nitric oxide.(Methods) Apoptosis of 3 colon cell lines were evaluated by cell growth curve and flow cytometry,the PGE_2 levels in cell culture supernatants were determined by competitive enzyme immunoassay method,and the(protein) expression of COX-1 and COX-2 were analyzed by Western blot.Results The production level of PGE_2 was increased with CSNO treated concentration and time.Using 500?mol/L CSNO treatment for 48h,the expression level of COX-1 and COX-2 protein increased.NASIDs can block the production of PGE_2 but had no effect on the inhibition of cell growth induced by GSNO.Conclusions GSNO can increase PGE_2(production) and induce COX-1 and COX-2 protein expression in a dose-and time-dependent manner.Higher concentrations of GSNO also can inhibite cell growth and induced apoptosis in all 3 cell lines.NSAIDs can block production of PEG2 but NSAIDs are no effect on cell growth.
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Therapeutic efficiency of advanced stage liver cancer is insufficiency,which has become the hot spot of research.Clinical observation found that prognosis of liver cancer with integrity amicula was better.It is generally accepted that silicon dioxiode(SiO2) can induce pulmonary fibrosis,resulting in the formation of pneumosilicosis.Use of SiO2 as embolism material induces hepatic fibrosis and forms the fibrosis amicula around the liver carcinoma,and then restrains the recurrence and metabasis of liver cancer,which has been turned into one of the aspect of liver carcinoma therapy.The possible mechanisms of inducing hepatic fibrosis by SiO2 are peroxidative damage by free radical,releasing of active cytokines,or inducing cell apoptosis and the activation of HSC etc.